NPI Code Detail JSON Logo

1366913980 NPI number — MY VITA WOMEN S WELLNESS CENTER PLLC

NPI Number: 1366913980
Health Care Provider/Practitioner: MY VITA WOMEN S WELLNESS CENTER PLLC

Information about “1366913980” NPI (MY VITA WOMEN S WELLNESS CENTER PLLC) exists in 1366913980 in HTML format HTML  |  1366913980 in plain Text format TXT  |  1366913980 in PDF (Portable Document Format) PDF  |  1366913980 in an XML format XML  formats.

NPI Number : 1366913980 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1366913980",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MY VITA WOMEN S WELLNESS CENTER 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": "926 N WILCREST DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOUSTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77079-3504",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "713-340-9005",
    "MailingAddressFaxNumber": "713-324-0550",
    "FirstLinePracticeLocationAddress": "4660 SWEETWATER BLVD STE 150",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SUGAR LAND",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77479-3164",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "713-340-9005",
    "PracticeLocationAddressFaxNumber": "713-324-0550",
    "EnumerationDate": "12/07/2018",
    "LastUpdateDate": "10/22/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "THOMPSON",
    "AuthorizedOfficialFirstName": "MARCEL",
    "AuthorizedOfficialMiddleName": "D",
    "AuthorizedOfficialTitle": "PROVIDER/OWNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DO",
    "AuthorizedOfficialTelephoneNumber": "713-623-1414",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261Q00000X",
          "TaxonomyName": "Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QP2300X",
          "TaxonomyName": "Primary Care Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207V00000X",
          "TaxonomyName": "Obstetrics & Gynecology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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