1831741602 NPI number — YVETTE S AMADOR

Table of content: YVETTE S AMADOR (NPI 1831741602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831741602 NPI number — YVETTE S AMADOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AMADOR
Provider First Name:
YVETTE
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1831741602
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7300 STATE HIGHWAY 121 STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCKINNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75070-1991
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-230-4632
Provider Business Mailing Address Fax Number:
817-776-4100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7300 STATE HIGHWAY 121 STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75070-1991
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-230-4632
Provider Business Practice Location Address Fax Number:
817-776-4100
Provider Enumeration Date:
07/11/2019

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: 310500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 311Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 311ZA0620X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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