NPI Code Detail JSON Logo

1467629709 NPI number — RODERICK MATHEW NUGENT M. D.

NPI Number: 1467629709
Health Care Provider/Practitioner: RODERICK MATHEW NUGENT M. D.

Information about “1467629709” NPI (RODERICK MATHEW NUGENT M. D.) exists in 1467629709 in HTML format HTML  |  1467629709 in plain Text format TXT  |  1467629709 in PDF (Portable Document Format) PDF  |  1467629709 in an XML format XML  formats.

NPI Number : 1467629709 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1467629709",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NUGENT",
    "FirstName": "RODERICK",
    "MiddleName": "MATHEW",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M. D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11508 ROYALSHIRE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DALLAS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75230-2914",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "214-365-9417",
    "MailingAddressFaxNumber": "214-365-8095",
    "FirstLinePracticeLocationAddress": "11508 ROYALSHIRE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75230-2914",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "214-365-9417",
    "PracticeLocationAddressFaxNumber": "214-365-8095",
    "EnumerationDate": "05/15/2008",
    "LastUpdateDate": "05/15/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207ZP0102X",
        "TaxonomyName": "Anatomic Pathology & Clinical Pathology Physician",
        "LicenseNumber": "D-4249",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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