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1467793695 NPI number — SUSAN P HARRELSON LMT, CLT-LANA

NPI Number: 1467793695
Health Care Provider/Practitioner: SUSAN P HARRELSON LMT, CLT-LANA

Information about “1467793695” NPI (SUSAN P HARRELSON LMT, CLT-LANA) exists in 1467793695 in HTML format HTML  |  1467793695 in plain Text format TXT  |  1467793695 in PDF (Portable Document Format) PDF  |  1467793695 in an XML format XML  formats.

NPI Number : 1467793695 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1467793695",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HARRELSON",
    "FirstName": "SUSAN",
    "MiddleName": "P",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMT, CLT-LANA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5047 SHERRI ANN RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN ANTONIO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78233-6213",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "210-237-4400",
    "MailingAddressFaxNumber": "210-828-0590",
    "FirstLinePracticeLocationAddress": "18626 HARDY OAK BLVD",
    "SecondLinePracticeLocationAddress": "SUITE 210",
    "PracticeLocationAddressCityName": "SAN ANTONIO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78258-4210",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "210-237-4229",
    "PracticeLocationAddressFaxNumber": "210-249-4911",
    "EnumerationDate": "03/13/2013",
    "LastUpdateDate": "10/23/2014",
    "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": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "MT016082",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "000573",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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