1639293137 NPI number — PATRICIA TOWAL M.ED LPC

Table of content: PATRICIA TOWAL M.ED LPC (NPI 1639293137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639293137 NPI number — PATRICIA TOWAL M.ED LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOWAL
Provider First Name:
PATRICIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.ED LPC
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:
1639293137
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/26/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1107 FM 1431 #327
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARBLE FALLS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78654-5006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-409-4690
Provider Business Mailing Address Fax Number:
801-409-4690

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1107 FM 1431 # 327
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARBLE FALLS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78654-5006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-409-4690
Provider Business Practice Location Address Fax Number:
801-409-4690
Provider Enumeration Date:
03/19/2007

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: 101YP2500X , with the licence number:  15285 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YS0200X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 15285 . This is a "TX LICENSE NUMBER LPC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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