NPI Code Detail JSON Logo

1174924450 NPI number — DAVID MALDONADO III MD PA

NPI Number: 1174924450
Health Care Provider/Practitioner: DAVID MALDONADO III MD PA

Information about “1174924450” NPI (DAVID MALDONADO III MD PA) exists in 1174924450 in HTML format HTML  |  1174924450 in plain Text format TXT  |  1174924450 in PDF (Portable Document Format) PDF  |  1174924450 in an XML format XML  formats.

NPI Number : 1174924450 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174924450",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "DAVID MALDONADO III MD PA",
    "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": "4843 COLLEYVILLE BLVD STE 251-328",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLLEYVILLE",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76034-3923",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "817-263-6116",
    "MailingAddressFaxNumber": "817-263-6117",
    "FirstLinePracticeLocationAddress": "4401 BOOTH CALLOWAY RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NORTH RICHLAND HILLS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76180-7371",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "817-263-6116",
    "PracticeLocationAddressFaxNumber": "817-263-6117",
    "EnumerationDate": "09/05/2014",
    "LastUpdateDate": "08/22/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MALDONADO",
    "AuthorizedOfficialFirstName": "DAVID",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PHYSICIAN/OWNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": "III",
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "817-703-4475",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207RC0200X",
          "TaxonomyName": "Critical Care Medicine (Internal Medicine) Physician",
          "LicenseNumber": "L2441",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RH0002X",
          "TaxonomyName": "Hospice and Palliative Medicine (Internal Medicine) Physician",
          "LicenseNumber": "L2441",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RP1001X",
          "TaxonomyName": "Pulmonary Disease Physician",
          "LicenseNumber": "L2441",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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