1881785392 NPI number — H.E.A.L., INC.

Table of content: (NPI 1881785392)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881785392 NPI number — H.E.A.L., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H.E.A.L., INC.
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:
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:
1881785392
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 348
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78403-0348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-883-9110
Provider Business Mailing Address Fax Number:
361-887-1080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 N SHORELINE BLVD
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78401-2824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-883-9110
Provider Business Practice Location Address Fax Number:
361-887-1080
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NICK
Authorized Official First Name:
NOEL
Authorized Official Middle Name:
NANI
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
361-883-9110

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  34031 , 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: 0A0233 . This is a "MEDICARE GROUP PTAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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