NPI Code Detail JSON Logo

1104014315 NPI number — AB CARDIOLOGY, PLLC

NPI Number: 1104014315
Health Care Provider/Practitioner: AB CARDIOLOGY, PLLC

Information about “1104014315” NPI (AB CARDIOLOGY, PLLC) exists in 1104014315 in HTML format HTML  |  1104014315 in plain Text format TXT  |  1104014315 in PDF (Portable Document Format) PDF  |  1104014315 in an XML format XML  formats.

NPI Number : 1104014315 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104014315",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "AB CARDIOLOGY, PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "12234 SHADOW CREEK PKWY STE 6106",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PEARLAND",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77584-7338",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "713-436-6653",
    "MailingAddressFaxNumber": "713-436-6365",
    "FirstLinePracticeLocationAddress": "6624 FANNIN ST STE 1990",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77030-2330",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "713-436-6653",
    "PracticeLocationAddressFaxNumber": "713-436-6365",
    "EnumerationDate": "10/12/2007",
    "LastUpdateDate": "02/28/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BUTKEVICH",
    "AuthorizedOfficialFirstName": "ALEXANDER",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "713-436-6653",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207RC0000X",
        "TaxonomyName": "Cardiovascular Disease Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "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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