Basic Information
Provider Information
NPI: 1043602824
EntityType: 2
ReplacementNPI:  
OrganizationName: MORGAN BACHELDOR LLC
LastName:  
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Mailing Information
Address1: PO BOX 938
Address2:  
City: ROWLETT
State: TX
PostalCode: 750300938
CountryCode: US
TelephoneNumber: 2142272457
FaxNumber: 2147640880
Practice Location
Address1: 17250 SADDLEWOOD RD
Address2:  
City: MONUMENT
State: CO
PostalCode: 801328327
CountryCode: US
TelephoneNumber: 2142272457
FaxNumber: 2147640880
Other Information
ProviderEnumerationDate: 03/03/2015
LastUpdateDate: 11/04/2019
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: BACHELDOR
AuthorizedOfficialFirstName: MORGAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 7196593685
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: CSFA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
246ZC0007X  Y193400000X SINGLE SPECIALTY GROUPTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherCertified First Assistant

No ID Information.


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