1871567610 NPI number — ANTHONY C MONTEIRO JR. DO

Table of content: ANTHONY C MONTEIRO JR. DO (NPI 1871567610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871567610 NPI number — ANTHONY C MONTEIRO JR. DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONTEIRO
Provider First Name:
ANTHONY
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871567610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6210 E HWY 290
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78723-1142
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-483-9596
Provider Business Mailing Address Fax Number:
512-406-6216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 MEDICAL PKWY
Provider Second Line Business Practice Location Address:
BLGD B, #220
Provider Business Practice Location Address City Name:
CEDAR PARK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78613-7464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-260-1581
Provider Business Practice Location Address Fax Number:
512-406-7309
Provider Enumeration Date:
02/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  212757 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: M7441 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 63348 . This is a "FALLON COMM HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA6081 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 160054172 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 188580802 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: J24199 . This is a "BLUE CARE ELECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0154911 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7012123 . This is a "CIGNA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7899252 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "ONE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "THREE RIVERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0700407 . This is a "EVERCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 38146 . This is a "HEALTHY START" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "TRICARE CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2015776 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 784223 . This is a "MVP HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: J24199 . This is a "BLUE SHIELD HMO BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 188580801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 409328 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: J24199 . This is a "BLUE SHIELD INDEMNITY" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com