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1083705362 NPI number — IRWIN ENDELMAN MD

NPI Number: 1083705362
Health Care Provider/Practitioner: IRWIN ENDELMAN MD

Information about “1083705362” NPI (IRWIN ENDELMAN MD) exists in 1083705362 in HTML format HTML  |  1083705362 in plain Text format TXT  |  1083705362 in PDF (Portable Document Format) PDF  |  1083705362 in an XML format XML  formats.

NPI Number : 1083705362 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083705362",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ENDELMAN",
    "FirstName": "IRWIN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1969",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COPPELL",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75019-1903",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "972-981-7927",
    "MailingAddressFaxNumber": "972-981-7928",
    "FirstLinePracticeLocationAddress": "6130 W. PARKER RD",
    "SecondLinePracticeLocationAddress": "MOB 1 STE 310",
    "PracticeLocationAddressCityName": "PLANO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75093",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "972-981-7927",
    "PracticeLocationAddressFaxNumber": "972-981-7928",
    "EnumerationDate": "09/28/2006",
    "LastUpdateDate": "03/19/2025",
    "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": "207V00000X",
          "TaxonomyName": "Obstetrics & Gynecology Physician",
          "LicenseNumber": "MD217913",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207V00000X",
          "TaxonomyName": "Obstetrics & Gynecology Physician",
          "LicenseNumber": "16727",
          "LicenseNumberStateCode": "SD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207V00000X",
          "TaxonomyName": "Obstetrics & Gynecology Physician",
          "LicenseNumber": "H2358",
          "LicenseNumberStateCode": "TX",
          "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."
      }
    }
  }
}
                
            

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