1942446653 NPI number — MRS. ACHAMMA ZACHARIA APN

Table of content: MRS. ACHAMMA ZACHARIA APN (NPI 1942446653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942446653 NPI number — MRS. ACHAMMA ZACHARIA APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZACHARIA
Provider First Name:
ACHAMMA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZACHARIA
Provider Other First Name:
SHARRY
Provider Other Middle Name:
ACHAMMA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
APN
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1942446653
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/31/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 840853
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-0853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-715-5000
Provider Business Mailing Address Fax Number:
972-715-9976

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6606 LBJ FWY STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-715-5000
Provider Business Practice Location Address Fax Number:
972-715-9976
Provider Enumeration Date:
12/30/2008

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: 363LA2200X , with the licence number:  AP117049 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP2300X , with the licence number: 643866 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LX0001X , with the licence number: 643866 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: AP117049 , 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: 206167302 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 206167304 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 206167303 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 206167311 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01446809 . This is a "RR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8N0232 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8430NZ . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com