Ingram Mall Fdcpa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

INGRAM MALL FDCPA

Practice address

6301 NW Loop 410 Ste L1A
San Antonio, TX 78238-3829

Phone

(210) 354-4867

Fax

(210) 681-6985

NPI assigned

Jan 27, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cyndee Castillo

Title

Office Manager

Phone

(210) 354-4867

Specialties & licenses 1

Addresses

Tax ID family

Ingram Mall FDC PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ingram Mall FDC PA

  • Dentist
  • San Antonio, TX
  • NPI 1992963136
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1073885729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 NW LOOP 410 STE L1A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782383829",
            "telephone_number": "210-354-4867",
            "fax_number": "210-681-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 NW LOOP 410 STE L1A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782383829",
            "telephone_number": "210-354-4867",
            "fax_number": "210-681-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGRAM MALL FDCPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "CYNDEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-354-4867"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul T Ingmundson, PH.D.
• Ingram Assisted Living LLC
• Ingram Hills Dental, PLLC
• Ingram Mall Dental Center, P.L.L.C.
• Ingram Mall FDC PA
• Alma Ingram Nlemadim
• Dennis Ingram
• George Steven Ingram, M.D.
• Megan Ingram, PT, DPT
• Samantha Nicole Ingram, CNIM

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.