1326101395 NPI number — DR. MELISSA MARIE SOMMERS OD

Table of content: DR. MELISSA MARIE SOMMERS OD (NPI 1326101395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326101395 NPI number — DR. MELISSA MARIE SOMMERS OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOMMERS
Provider First Name:
MELISSA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OD
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:
1326101395
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 EAST NASA PARKWAY
Provider Second Line Business Mailing Address:
SUITE 70
Provider Business Mailing Address City Name:
WEBSTER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-332-0698
Provider Business Mailing Address Fax Number:
281-332-6689

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 EAST NASA PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 70
Provider Business Practice Location Address City Name:
WEBSTER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77598
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-332-0698
Provider Business Practice Location Address Fax Number:
281-332-6689
Provider Enumeration Date:
12/19/2006

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: 152W00000X , with the licence number:  2546TG , 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: 80902Q . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 6872047 . This is a "CIGNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5481386 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0790330001 . This is a "NSC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00E67E . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 2546TG . This is a "TEXAS OPTOMETRY LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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