1932435443 NPI number — MS. LESLEY MICHELLE BIPPERT AUDIOLOGIST

Table of content: MS. LESLEY MICHELLE BIPPERT AUDIOLOGIST (NPI 1932435443)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932435443 NPI number — MS. LESLEY MICHELLE BIPPERT AUDIOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIPPERT
Provider First Name:
LESLEY
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
AUDIOLOGIST
Provider Gender Code:
F

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:
1932435443
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2679
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78299-2679
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-616-0096
Provider Business Mailing Address Fax Number:
210-614-1003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7940 FLOYD CURL
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-3907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-616-0096
Provider Business Practice Location Address Fax Number:
210-614-1003
Provider Enumeration Date:
10/19/2009

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: 231H00000X , with the licence number:  80103 , 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: 530294 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 112774801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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