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1104599497 NPI number — KIMBERLY NICOLE MENCHACA PHARMD

NPI Number: 1104599497
Health Care Provider/Practitioner: KIMBERLY NICOLE MENCHACA PHARMD

Information about “1104599497” NPI (KIMBERLY NICOLE MENCHACA PHARMD) exists in 1104599497 in HTML format HTML  |  1104599497 in plain Text format TXT  |  1104599497 in PDF (Portable Document Format) PDF  |  1104599497 in an XML format XML  formats.

NPI Number : 1104599497 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104599497",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MENCHACA",
    "FirstName": "KIMBERLY",
    "MiddleName": "NICOLE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "PHARMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "12949 EASTBROOK DR APT 82",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EL PASO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "79938-5510",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "915-540-6744",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1607 N ZARAGOZA RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EL PASO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "79936-7908",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "915-856-0071",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/01/2021",
    "LastUpdateDate": "08/01/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "68877",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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