KEVIN LANE DO Full NPI Record 1003001579
Family Medicine in Quanah, TX
Complete NPI Dataset
The following table represents the complete NPI 1003001579 dataset for Kevin Lane Do in 404 MERCER ST QUANAH, TX 79252. The data table includes a list of all field names, values and definitions of the complete NPI record. The NPI dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.
| Name | Value | Definition |
|---|---|---|
| NPI | 1003001579 | The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’. |
| Entity Type Code | 2 | The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’. |
| Employer Identification Number EIN | UNAVAIL | 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 Organization Name Legal Business Name | KEVIN LANE DO PA | The second 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 Other Organization Name | KEVIN LANE DO | The city name in the location address of the provider being identified. |
| Provider Other Organization Name Type Code | 3 | The State code in the location of the provider being identified. |
| Provider First Line Business Mailing Address | PO BOX 359 | The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’. |
| Provider Business Mailing Address City Name | QUANAH | The city name in the mailing address of the provider being identified. |
| Provider Business Mailing Address State Name | TX | The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’. |
| Provider Business Mailing Address Postal Code | 792520359 | The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’. |
| Provider Business Mailing Address Country Code If outside U S | US | The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’. |
| Provider Business Mailing Address Telephone Number | 9406635111 | The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’. |
| Provider Business Mailing Address Fax Number | 9406635899 | The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’. |
| Provider First Line Business Practice Location Address | 404 MERCER ST | 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 | QUANAH | The city name in the location address of the provider being identified. |
| Provider Business Practice Location Address State Name | TX | The State code in the location of the provider being identified. |
| Provider Business Practice Location Address Postal Code | 792524026 | 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 | 9406635111 | The telephone number associated with the location address of the provider being identified. |
| Provider Business Practice Location Address Fax Number | 9406635899 | The fax number associated with the location address of the provider being identified. |
| Provider Enumeration Date | 9/7/2007 | The date the provider was assigned a unique identifier (assigned an NPI). |
| Last Update Date | 9/7/2007 | The date that a record was last updated or changed. |
| Authorized Official Last Name | FLANNERY | The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
| Authorized Official First Name | KIMBERLY | The first name of the authorized official. |
| Authorized Official Middle Name | R | The middle name of the authorized official. |
| Authorized Official Title or Position | PRACTICE ADMINISTRATOR | The title or position of the authorized official. |
| Authorized Official Telephone Number | 9406635111 | The 10-position telephone number of the authorized official. |
| Healthcare Provider Taxonomy Code 1 | 207Q00000X | Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
| Provider License Number 1 | L8579 | The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
| 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 | |
| Healthcare Provider Taxonomy Group 1 | 193400000X SINGLE SPECIALTY GROUP | |