1861628950 NPI number — ANN MARIE CASE MD

Table of content: ANN MARIE CASE MD (NPI 1861628950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861628950 NPI number — ANN MARIE CASE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASE
Provider First Name:
ANN MARIE
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:
1861628950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 BARBARA JORDAN BLVD
Provider Second Line Business Mailing Address:
SUITE #200
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78723-3077
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-628-1932
Provider Business Mailing Address Fax Number:
512-628-1801

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4900 MUELLER BLVD
Provider Second Line Business Practice Location Address:
PEDIATRIC PALLIATIVE CARE
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78723-3079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-324-0197
Provider Business Practice Location Address Fax Number:
512-324-0748
Provider Enumeration Date:
06/03/2009

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: 2080H0002X , with the licence number:  J5146 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: J5146 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com