NPI Code Detail JSON Logo

1033777115 NPI number — CAROLYN NICOLE YOUNG DPT

NPI Number: 1033777115
Health Care Provider/Practitioner: CAROLYN NICOLE YOUNG DPT

Information about “1033777115” NPI (CAROLYN NICOLE YOUNG DPT) exists in 1033777115 in HTML format HTML  |  1033777115 in plain Text format TXT  |  1033777115 in PDF (Portable Document Format) PDF  |  1033777115 in an XML format XML  formats.

NPI Number : 1033777115 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033777115",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "YOUNG",
    "FirstName": "CAROLYN",
    "MiddleName": "NICOLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CARR",
    "OtherFirstName": "CAROLYN",
    "OtherMiddleName": "NICOLE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "8212 BRIDGE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORTH RICHLAND HILLS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76180-5534",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8651 JOHN T WHITE RD STE 121",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORT WORTH",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76120-2766",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "817-542-0714",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/03/2019",
    "LastUpdateDate": "06/03/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "1317969",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.