NPI Code Detail JSON Logo

1003515677 NPI number — MOTHER'S MAGICAL MILK

NPI Number: 1003515677
Health Care Provider/Practitioner: MOTHER'S MAGICAL MILK

Information about “1003515677” NPI (MOTHER'S MAGICAL MILK) exists in 1003515677 in HTML format HTML  |  1003515677 in plain Text format TXT  |  1003515677 in PDF (Portable Document Format) PDF  |  1003515677 in an XML format XML  formats.

NPI Number : 1003515677 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003515677",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MOTHER'S MAGICAL MILK",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4602 SPRING LAKE PKWY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MANSFIELD",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76063-5590",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-215-9077",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1015 E DALLAS ST STE 2",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MANSFIELD",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76063-2029",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "817-405-9661",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/02/2023",
    "LastUpdateDate": "03/02/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HORDGE",
    "AuthorizedOfficialFirstName": "TENISE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER, OPERATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "IBCLC",
    "AuthorizedOfficialTelephoneNumber": "817-405-9661",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261Q00000X",
          "TaxonomyName": "Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "174N00000X",
          "TaxonomyName": "Lactation Consultant (Non-RN)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.