{
"Npi": {
"NPI": "1366775850",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GREATER TEXAS ANESTHESIA & PAIN MANAGEMENT, PA",
"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": "5760 LEGACY DR # B3-119",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLANO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75024-7102",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "940-458-2828",
"MailingAddressFaxNumber": "940-458-2522",
"FirstLinePracticeLocationAddress": "807 N 4TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SANGER",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76266-4414",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "940-458-2828",
"PracticeLocationAddressFaxNumber": "940-458-2522",
"EnumerationDate": "09/15/2009",
"LastUpdateDate": "09/17/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AGHA",
"AuthorizedOfficialFirstName": "TASNEEM",
"AuthorizedOfficialMiddleName": "K.",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "940-458-2828",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207LP2900X",
"TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
"LicenseNumber": "K4347",
"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."
}
}
}
}