{
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"IsOrgSubpart": "N",
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"OrgName": "NIDRAVEDA, P.A.",
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"NamePrefix": null,
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"FirstLineMailingAddress": "4358 LOCKHILL SELMA RD STE 106",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHAVANO PARK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78249-4167",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "210-686-5000",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4358 LOCKHILL SELMA RD STE 106",
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"PracticeLocationAddressCityName": "SHAVANO PARK",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressTelephoneNumber": "210-686-5000",
"PracticeLocationAddressFaxNumber": "210-239-5060",
"EnumerationDate": "01/10/2014",
"LastUpdateDate": "05/22/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BHANDARI",
"AuthorizedOfficialFirstName": "HANUL",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "210-686-5000",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QS1200X",
"TaxonomyName": "Sleep Disorder Diagnostic Clinic/Center",
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM2500X",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}