1932741725 NPI number — SAMIHA JOANNE CRUZ LPC

Table of content: SAMIHA JOANNE CRUZ LPC (NPI 1932741725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932741725 NPI number — SAMIHA JOANNE CRUZ LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRUZ
Provider First Name:
SAMIHA
Provider Middle Name:
JOANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRUZ
Provider Other First Name:
SAMIHA
Provider Other Middle Name:
JOANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1932741725
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 749
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHARR
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78577-1614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-362-8290
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2821 MICHAELANGELO DR STE 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78539-1423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-362-8290
Provider Business Practice Location Address Fax Number:
956-362-8295
Provider Enumeration Date:
10/13/2019

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: 101YP2500X , with the licence number:  77028 , 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)