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1265893085 NPI number — PELOZA SURGICAL SERVICES, PLLC

NPI Number: 1265893085
Health Care Provider/Practitioner: PELOZA SURGICAL SERVICES, PLLC

Information about “1265893085” NPI (PELOZA SURGICAL SERVICES, PLLC) exists in 1265893085 in HTML format HTML  |  1265893085 in plain Text format TXT  |  1265893085 in PDF (Portable Document Format) PDF  |  1265893085 in an XML format XML  formats.

NPI Number : 1265893085 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265893085",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PELOZA SURGICAL SERVICES, PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "17980 DALLAS PKWY",
    "SecondLineMailingAddress": "SUITE 300",
    "MailingAddressCityName": "DALLAS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75287-6702",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "214-378-7200",
    "MailingAddressFaxNumber": "214-378-7200",
    "FirstLinePracticeLocationAddress": "17980 DALLAS PKWY",
    "SecondLinePracticeLocationAddress": "SUITE 300",
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75287-6702",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "214-378-7200",
    "PracticeLocationAddressFaxNumber": "214-378-7200",
    "EnumerationDate": "03/08/2016",
    "LastUpdateDate": "03/18/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PELOZA",
    "AuthorizedOfficialFirstName": "JOHN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGING PHYSICIAN",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "214-378-7200",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "PA01810",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207XS0117X",
          "TaxonomyName": "Orthopaedic Surgery of the Spine Physician",
          "LicenseNumber": "G7094",
          "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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