1720286347 NPI number — HOPE FOLARIN MD

Table of content: HOPE FOLARIN MD (NPI 1720286347)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720286347 NPI number — HOPE FOLARIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FOLARIN
Provider First Name:
HOPE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1720286347
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4515 SETON CENTER PKWY
Provider Second Line Business Mailing Address:
SUITE 215-CREDENTIALING
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78759-5290
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-231-5516
Provider Business Mailing Address Fax Number:
512-406-6216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3828 S 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78704-7048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-443-1311
Provider Business Practice Location Address Fax Number:
512-406-6266
Provider Enumeration Date:
07/05/2007

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: 390200000X , with the licence number:  0116019834 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: N7086 , 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: 217673703 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 217673704 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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