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1134631542 NPI number — JAIME GAMBOA FNP

NPI Number: 1134631542
Health Care Provider/Practitioner: JAIME GAMBOA FNP

Information about “1134631542” NPI (JAIME GAMBOA FNP) exists in 1134631542 in HTML format HTML  |  1134631542 in plain Text format TXT  |  1134631542 in PDF (Portable Document Format) PDF  |  1134631542 in an XML format XML  formats.

NPI Number : 1134631542 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1134631542",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GAMBOA",
    "FirstName": "JAIME",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TYLER",
    "OtherFirstName": "JAIME",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "FNP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3591 MCKINNEY ST STE 400",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MELISSA",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75454-9504",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "972-464-1611",
    "MailingAddressFaxNumber": "972-913-6216",
    "FirstLinePracticeLocationAddress": "3591 MCKINNEY ST STE 400",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MELISSA",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75454",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "972-464-1611",
    "PracticeLocationAddressFaxNumber": "972-913-6216",
    "EnumerationDate": "10/26/2017",
    "LastUpdateDate": "12/07/2018",
    "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": "363L00000X",
        "TaxonomyName": "Nurse Practitioner",
        "LicenseNumber": "AP135470",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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