1427058627 NPI number — LAURA I. MOWLES WHCNP

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427058627 NPI number — LAURA I. MOWLES WHCNP

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MOWLES

Provider First Name:

LAURA

Provider Middle Name:

I.

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

WHCNP

Provider Gender Code:

F

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:

1427058627

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/07/2009

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 660599

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:

75266-0599

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

5201 HARRY HINES BLVD

Provider Second Line Business Practice Location Address:

WISH TUBAL CLINIC

Provider Business Practice Location Address City Name:

DALLAS

Provider Business Practice Location Address State Name:

TX

Provider Business Practice Location Address Postal Code:

75235-7708

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

214-590-5306

Provider Business Practice Location Address Fax Number:

214-590-2798

Provider Enumeration Date:

07/28/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 363LW0102X , with the licence number:  604249 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 144925810 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925807 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925808 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925811 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925812 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925804 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925809 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925803 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925805 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925802 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 144925806 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 8N4814 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".