NPI |
1265790497 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Entity Type Code |
2 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Employer Identification Number EIN |
|
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified. |
Provider Organization Name Legal Business Name |
SUGAR LAND GARDENS |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
Provider First Line Business Practice Location Address |
4422 RIVERSTONE BLVD |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address City Name |
MISSOURI CITY |
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
Provider Business Practice Location Address State Name |
TX |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address Postal Code |
774597150 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
6016246487 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Fax Number |
6017090832 |
The fax number associated with the location
address of the provider being identified. |
Provider Enumeration Date |
4/25/2012 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Last Update Date |
10/18/2012 |
The date that a record was last updated or changed. |
Authorized Official Last Name |
STIGLER |
The date the provider was assigned a unique identifier (assigned an NPI). |
Authorized Official First Name |
ROBERT |
The first name of the authorized official. |
Authorized Official Middle Name |
D |
The middle name of the authorized official. |
Authorized Official Title or Position |
OPERATOR |
The title or position of the authorized official. |
Authorized Official Telephone Number |
2814995040 |
The 10-position telephone number of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
314000000X |
The 10-position telephone number of the authorized official. |
Provider License Number State Code 1 |
TX |
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Organization Subpart |
N |
|
Authorized Official Name Prefix Text |
MR. |
|
Authorized Official Name Suffix Text |
JR. |
|