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1508654898 NPI number — MAC HEALTH ASSOCIATION

NPI Number: 1508654898
Health Care Provider/Practitioner: MAC HEALTH ASSOCIATION

Information about “1508654898” NPI (MAC HEALTH ASSOCIATION) exists in 1508654898 in HTML format HTML  |  1508654898 in plain Text format TXT  |  1508654898 in PDF (Portable Document Format) PDF  |  1508654898 in an XML format XML  formats.

NPI Number : 1508654898 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508654898",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MAC HEALTH ASSOCIATION",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5900 BALCONES DR # 17729",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AUSTIN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78731-4257",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "945-367-1054",
    "MailingAddressFaxNumber": "945-523-0453",
    "FirstLinePracticeLocationAddress": "5050 QUORUM DR STE 700",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75254-1410",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "945-367-1054",
    "PracticeLocationAddressFaxNumber": "945-523-0453",
    "EnumerationDate": "04/28/2025",
    "LastUpdateDate": "05/12/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "COHEN",
    "AuthorizedOfficialFirstName": "DAVID",
    "AuthorizedOfficialMiddleName": "ADAV",
    "AuthorizedOfficialTitle": "NON-CLINICAL STAFF",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "909-224-3786",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103K00000X",
        "TaxonomyName": "Behavior Analyst",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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