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1053636191 NPI number — ADVANTAGE RENAL CARE LLC

NPI Number: 1053636191
Health Care Provider/Practitioner: ADVANTAGE RENAL CARE LLC

Information about “1053636191” NPI (ADVANTAGE RENAL CARE LLC) exists in 1053636191 in HTML format HTML  |  1053636191 in plain Text format TXT  |  1053636191 in PDF (Portable Document Format) PDF  |  1053636191 in an XML format XML  formats.

NPI Number : 1053636191 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053636191",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ADVANTAGE RENAL CARE LLC",
    "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": "3169 CALLE MARAVILLOSA",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BROWNSVILLE",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78526-1240",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "956-466-8237",
    "MailingAddressFaxNumber": "888-943-2228",
    "FirstLinePracticeLocationAddress": "1601 E ALTON GLOOR BLVD",
    "SecondLinePracticeLocationAddress": "STE 105",
    "PracticeLocationAddressCityName": "BROWNSVILLE",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78526-3902",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "956-466-8237",
    "PracticeLocationAddressFaxNumber": "888-943-2228",
    "EnumerationDate": "04/01/2010",
    "LastUpdateDate": "10/15/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ISBELL",
    "AuthorizedOfficialFirstName": "ROBERT",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "LLC MANAGER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RN",
    "AuthorizedOfficialTelephoneNumber": "956-466-8237",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QE0700X",
        "TaxonomyName": "End-Stage Renal Disease (ESRD) Treatment Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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