1962831800 NPI number — ANA ARENIVAS PHD

Table of content: ANA ARENIVAS PHD (NPI 1962831800)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962831800 NPI number — ANA ARENIVAS PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARENIVAS
Provider First Name:
ANA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD
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:
1962831800
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2150 W. 18TH STREET
Provider Second Line Business Mailing Address:
#300
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-426-0027
Provider Business Mailing Address Fax Number:
713-526-1422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
902 FROSTWOOD DR
Provider Second Line Business Practice Location Address:
#142
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-827-8266
Provider Business Practice Location Address Fax Number:
713-827-0132
Provider Enumeration Date:
11/01/2013

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: 103G00000X , with the licence number:  05245 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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