NPI Code Detail JSON Logo

1396916706 NPI number — ELLY E. POURASEF AUD, CCC/A

NPI Number: 1396916706
Health Care Provider/Practitioner: ELLY E. POURASEF AUD, CCC/A

Information about “1396916706” NPI (ELLY E. POURASEF AUD, CCC/A) exists in 1396916706 in HTML format HTML  |  1396916706 in plain Text format TXT  |  1396916706 in PDF (Portable Document Format) PDF  |  1396916706 in an XML format XML  formats.

NPI Number : 1396916706 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396916706",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "POURASEF",
    "FirstName": "ELLY",
    "MiddleName": "E.",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "AUD, CCC/A",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9071 SOUTH 1300 WEST",
    "SecondLineMailingAddress": "SUITE 100",
    "MailingAddressCityName": "WEST JORDAN",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84088",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "801-938-1117",
    "MailingAddressFaxNumber": "801-938-2771",
    "FirstLinePracticeLocationAddress": "908 TOWN AND COUNTRY BLVD.",
    "SecondLinePracticeLocationAddress": "SUITE 120",
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77024-2208",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "713-984-7562",
    "PracticeLocationAddressFaxNumber": "866-961-3161",
    "EnumerationDate": "03/13/2008",
    "LastUpdateDate": "04/29/2011",
    "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": "231H00000X",
          "TaxonomyName": "Audiologist",
          "LicenseNumber": "80074",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "237600000X",
          "TaxonomyName": "Audiologist-Hearing Aid Fitter",
          "LicenseNumber": "80074",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.