NPI Code Detail JSON Logo

1205656089 NPI number — SPINE CARE & PAIN MANAGEMENT OF SAN ANTONIO LLC

NPI Number: 1205656089
Health Care Provider/Practitioner: SPINE CARE & PAIN MANAGEMENT OF SAN ANTONIO LLC

Information about “1205656089” NPI (SPINE CARE & PAIN MANAGEMENT OF SAN ANTONIO LLC) exists in 1205656089 in HTML format HTML  |  1205656089 in plain Text format TXT  |  1205656089 in PDF (Portable Document Format) PDF  |  1205656089 in an XML format XML  formats.

NPI Number : 1205656089 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205656089",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "SPINE CARE & PAIN MANAGEMENT OF SAN ANTOINO LLC",
    "ParentOrgTIN": null,
    "OrgName": "SPINE CARE & PAIN MANAGEMENT OF SAN ANTONIO LLC",
    "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": "20079 STONE OAK PKWY STE 1245",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN ANTONIO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78258-6957",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "726-203-4561",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "102 PALO ALTO RD STE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN ANTONIO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78211-3879",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "210-545-0087",
    "PracticeLocationAddressFaxNumber": "210-545-3455",
    "EnumerationDate": "10/15/2024",
    "LastUpdateDate": "10/15/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BAILEY",
    "AuthorizedOfficialFirstName": "STELLA",
    "AuthorizedOfficialMiddleName": "C",
    "AuthorizedOfficialTitle": "BILLING",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "726-203-4561",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208VP0014X",
        "TaxonomyName": "Interventional Pain Medicine Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "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."
      }
    }
  }
}
                
            

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