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1215272406 NPI number — GENOTOX LABORATORIES LTD

NPI Number: 1215272406
Health Care Provider/Practitioner: GENOTOX LABORATORIES LTD

Information about “1215272406” NPI (GENOTOX LABORATORIES LTD) exists in 1215272406 in HTML format HTML  |  1215272406 in plain Text format TXT  |  1215272406 in PDF (Portable Document Format) PDF  |  1215272406 in an XML format XML  formats.

NPI Number : 1215272406 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215272406",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GENOTOX LABORATORIES LTD",
    "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": "2170 WOODWARD",
    "SecondLineMailingAddress": "SUITE 100",
    "MailingAddressCityName": "AUSTIN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78744-1074",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "512-600-6601",
    "MailingAddressFaxNumber": "512-600-6602",
    "FirstLinePracticeLocationAddress": "2170 WOODWARD",
    "SecondLinePracticeLocationAddress": "SUITE 100",
    "PracticeLocationAddressCityName": "AUSTIN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78744-1074",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-600-6601",
    "PracticeLocationAddressFaxNumber": "512-600-6602",
    "EnumerationDate": "11/29/2012",
    "LastUpdateDate": "07/21/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MCCARTY",
    "AuthorizedOfficialFirstName": "MATTHEW",
    "AuthorizedOfficialMiddleName": "FREDERICK",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "512-600-6601",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "291U00000X",
          "TaxonomyName": "Clinical Medical Laboratory",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "291U00000X",
          "TaxonomyName": "Clinical Medical Laboratory",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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