1922365741 NPI number — DANIEL P HARVILLE FITTER/DISPENSER

Table of content: DANIEL P HARVILLE FITTER/DISPENSER (NPI 1922365741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922365741 NPI number — DANIEL P HARVILLE FITTER/DISPENSER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARVILLE
Provider First Name:
DANIEL
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FITTER/DISPENSER
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:
1922365741
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
421 LOOP 236
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
QUEEN CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75572-2272
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-244-5117
Provider Business Mailing Address Fax Number:
903-796-9669

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
421 LOOP 236
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUEEN CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75572-2272
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-244-5117
Provider Business Practice Location Address Fax Number:
903-796-9669
Provider Enumeration Date:
04/18/2012

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: 237700000X , with the licence number:  80524 , 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)





Copyright © 2007-2025 www.npivalidator.com