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1063527679 NPI number — RONALD DWAYNE JOHNSON RN

NPI Number: 1063527679
Health Care Provider/Practitioner: RONALD DWAYNE JOHNSON RN

Information about “1063527679” NPI (RONALD DWAYNE JOHNSON RN) exists in 1063527679 in HTML format HTML  |  1063527679 in plain Text format TXT  |  1063527679 in PDF (Portable Document Format) PDF  |  1063527679 in an XML format XML  formats.

NPI Number : 1063527679 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063527679",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JOHNSON",
    "FirstName": "RONALD",
    "MiddleName": "DWAYNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6151 SHEFFIELD LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LEAGUE CITY",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77573-6290",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "281-554-6233",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2002 HOLCOMBE BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77030-4211",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "713-791-1414",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/21/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "163W00000X",
        "TaxonomyName": "Registered Nurse",
        "LicenseNumber": "252623",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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