NPI Code Detail JSON Logo

1376814616 NPI number — PREMIER HOUSECALL PHYSICIANS LLC

NPI Number: 1376814616
Health Care Provider/Practitioner: PREMIER HOUSECALL PHYSICIANS LLC

Information about “1376814616” NPI (PREMIER HOUSECALL PHYSICIANS LLC) exists in 1376814616 in HTML format HTML  |  1376814616 in plain Text format TXT  |  1376814616 in PDF (Portable Document Format) PDF  |  1376814616 in an XML format XML  formats.

NPI Number : 1376814616 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376814616",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PREMIER HOUSECALL PHYSICIANS LLC",
    "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": "1015 W CENTERVILLE RD",
    "SecondLineMailingAddress": "#118",
    "MailingAddressCityName": "GARLAND",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75041-5914",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "214-766-1955",
    "MailingAddressFaxNumber": "972-808-6035",
    "FirstLinePracticeLocationAddress": "1015 W CENTERVILLE RD",
    "SecondLinePracticeLocationAddress": "#118",
    "PracticeLocationAddressCityName": "GARLAND",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75041-5914",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "214-766-1955",
    "PracticeLocationAddressFaxNumber": "972-808-6035",
    "EnumerationDate": "01/18/2012",
    "LastUpdateDate": "05/25/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "OSUAGWU",
    "AuthorizedOfficialFirstName": "CHUKWUMA",
    "AuthorizedOfficialMiddleName": "C",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "214-766-1955",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "M4412",
          "LicenseNumberStateCode": "TX",
          "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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