NPI Code Detail JSON Logo

1205134715 NPI number — ELITE MEDICAL SERVICES

NPI Number: 1205134715
Health Care Provider/Practitioner: ELITE MEDICAL SERVICES

Information about “1205134715” NPI (ELITE MEDICAL SERVICES) exists in 1205134715 in HTML format HTML  |  1205134715 in plain Text format TXT  |  1205134715 in PDF (Portable Document Format) PDF  |  1205134715 in an XML format XML  formats.

NPI Number : 1205134715 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205134715",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ELITE MEDICAL SERVICES",
    "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": "PO BOX 189",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BEEVILLE",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78104-0189",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "361-358-1103",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1236 FM 2824",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BEEVILLE",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78102-8229",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "361-358-1103",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/08/2011",
    "LastUpdateDate": "07/08/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CASTILLA",
    "AuthorizedOfficialFirstName": "ANDREA",
    "AuthorizedOfficialMiddleName": "KAE",
    "AuthorizedOfficialTitle": "SOLE PROPRIETOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "R.N, M.S.N.",
    "AuthorizedOfficialTelephoneNumber": "361-358-1103",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207RP1001X",
          "TaxonomyName": "Pulmonary Disease Physician",
          "LicenseNumber": "M2475",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RI0200X",
          "TaxonomyName": "Infectious Disease Physician",
          "LicenseNumber": "M2475",
          "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."
        }
      ]
    }
  }
}
                
            

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