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1467159616 NPI number — ADDIE LYNN MARQUEZ LPA-INDEPENDENT

NPI Number: 1467159616
Health Care Provider/Practitioner: ADDIE LYNN MARQUEZ LPA-INDEPENDENT

Information about “1467159616” NPI (ADDIE LYNN MARQUEZ LPA-INDEPENDENT) exists in 1467159616 in HTML format HTML  |  1467159616 in plain Text format TXT  |  1467159616 in PDF (Portable Document Format) PDF  |  1467159616 in an XML format XML  formats.

NPI Number : 1467159616 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1467159616",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARQUEZ",
    "FirstName": "ADDIE",
    "MiddleName": "LYNN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LPA-INDEPENDENT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GOODSON",
    "OtherFirstName": "ADDIE",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "GOT MARRIED RECENTLY",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2237 RIDGE RD STE 101",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROCKWALL",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75087-5161",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "972-771-3969",
    "MailingAddressFaxNumber": "972-771-8258",
    "FirstLinePracticeLocationAddress": "2237 RIDGE RD STE 101",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROCKWALL",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75087-5161",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "972-771-3969",
    "PracticeLocationAddressFaxNumber": "972-771-8258",
    "EnumerationDate": "02/08/2023",
    "LastUpdateDate": "11/20/2025",
    "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": "103T00000X",
        "TaxonomyName": "Psychologist",
        "LicenseNumber": "38441",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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