NPI Code Detail JSON Logo

1154942845 NPI number — BLAKE TORRES PHARMD

NPI Number: 1154942845
Health Care Provider/Practitioner: BLAKE TORRES PHARMD

Information about “1154942845” NPI (BLAKE TORRES PHARMD) exists in 1154942845 in HTML format HTML  |  1154942845 in plain Text format TXT  |  1154942845 in PDF (Portable Document Format) PDF  |  1154942845 in an XML format XML  formats.

NPI Number : 1154942845 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154942845",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TORRES",
    "FirstName": "BLAKE",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHARMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TORRES",
    "OtherFirstName": "CHARLES",
    "OtherMiddleName": "BLAKE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PHARMD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "501 W SEVIER ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BENTON",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72015-4215",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "501-778-3151",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "501 W SEVIER ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BENTON",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72015-4215",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "501-778-3151",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/04/2020",
    "LastUpdateDate": "10/29/2020",
    "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": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "PD12722",
        "LicenseNumberStateCode": "AR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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