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1255948626 NPI number — LAUREN MICHELLE BAULCH DPT

NPI Number: 1255948626
Health Care Provider/Practitioner: LAUREN MICHELLE BAULCH DPT

Information about “1255948626” NPI (LAUREN MICHELLE BAULCH DPT) exists in 1255948626 in HTML format HTML  |  1255948626 in plain Text format TXT  |  1255948626 in PDF (Portable Document Format) PDF  |  1255948626 in an XML format XML  formats.

NPI Number : 1255948626 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255948626",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAULCH",
    "FirstName": "LAUREN",
    "MiddleName": "MICHELLE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "NITOSKI",
    "OtherFirstName": "LAUREN",
    "OtherMiddleName": "MICHELLE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "11910 ARBOR DOWNS RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AUSTIN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78748-2039",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "904-347-4724",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11215 S INTERSTATE 35 STE 102",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "AUSTIN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78747-1864",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-292-1908",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/29/2020",
    "LastUpdateDate": "09/29/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "1166730",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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