1932497443 NPI number — TOTAL SENIOR EAR CARE, CORP

Table of content: KIM PATRICIA NICOLE PLATON VALENZUELA MD (NPI 1538863642)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932497443 NPI number — TOTAL SENIOR EAR CARE, CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL SENIOR EAR CARE, CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1932497443
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9535 FOREST LN
Provider Second Line Business Mailing Address:
SUITE #123
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75243-5900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-382-3813
Provider Business Mailing Address Fax Number:
214-382-3815

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9535 FOREST LANE
Provider Second Line Business Practice Location Address:
SUITE 123
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-382-3813
Provider Business Practice Location Address Fax Number:
214-382-3815
Provider Enumeration Date:
07/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
HILL
Authorized Official First Name:
HARLAN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
214-382-3813

Provider Taxonomy Codes

  • Taxonomy code: 207YX0901X , with the licence number:  E9290 , 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)





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