1992810535 NPI number — DR. MERCEDES TATLONGHARI SULIT DMD

Table of content: DR. MERCEDES TATLONGHARI SULIT DMD (NPI 1992810535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992810535 NPI number — DR. MERCEDES TATLONGHARI SULIT DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SULIT
Provider First Name:
MERCEDES
Provider Middle Name:
TATLONGHARI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
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:
1992810535
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2646 SOUTH LOOP WEST
Provider Second Line Business Mailing Address:
SUITE 575
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2646 SOUTH LOOP WEST
Provider Second Line Business Practice Location Address:
SUITE 575
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-838-7019
Provider Business Practice Location Address Fax Number:
713-838-7026
Provider Enumeration Date:
08/21/2006

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: 122300000X , with the licence number:  12317686 , 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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