1699905596 NPI number — NSC CONSULTANTS, PA

Table of content: (NPI 1699905596)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699905596 NPI number — NSC CONSULTANTS, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NSC CONSULTANTS, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEUROSURGERY AND SPINE CONSULTANTS
Provider Other Organization Name Type Code:
3
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:
1699905596
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 654355
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:
75265-4355
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-255-8935
Provider Business Mailing Address Fax Number:
210-255-8026

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4611 CENTERVIEW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78228-1202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-255-8935
Provider Business Practice Location Address Fax Number:
210-255-8026
Provider Enumeration Date:
07/26/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ZAVALA
Authorized Official First Name:
GERARDO
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
210-255-8935

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  M9760 , 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: 0088SP . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 196529505 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 208351102 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 208351101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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