1871928218 NPI number — MRS. SELIECE DODDS MORROW CNS

Table of content: MRS. SELIECE DODDS MORROW CNS (NPI 1871928218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871928218 NPI number — MRS. SELIECE DODDS MORROW CNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORROW
Provider First Name:
SELIECE
Provider Middle Name:
DODDS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DODDS
Provider Other First Name:
SELIECE
Provider Other Middle Name:
RAE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1871928218
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/09/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4439
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77210-4439
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-792-2991
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1515 HOLCOMBE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-4009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-792-6161
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/04/2013

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: 364S00000X , with the licence number:  2013007545 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364S00000X , with the licence number: AP124466/RN 809236 , 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: 362975001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".