{
"Npi": {
"NPI": "1083797617",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "A-MED, INC.",
"ParentOrgTIN": null,
"OrgName": "A-MED INC",
"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": "19073 I45 SOUTH",
"SecondLineMailingAddress": "#195",
"MailingAddressCityName": "SHENANDOAH",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77385-8728",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "936-321-7614",
"MailingAddressFaxNumber": "936-271-7648",
"FirstLinePracticeLocationAddress": "19073 I-45 S",
"SecondLinePracticeLocationAddress": "#195",
"PracticeLocationAddressCityName": "SHENANDOAH",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77385-8743",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "936-321-7614",
"PracticeLocationAddressFaxNumber": "936-271-7648",
"EnumerationDate": "10/24/2006",
"LastUpdateDate": "01/09/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MANER",
"AuthorizedOfficialFirstName": "SANDI",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "936-321-7614",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}