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1568200491 NPI number — MAKINNA SERRATA

NPI Number: 1568200491
Health Care Provider/Practitioner: MAKINNA SERRATA

Information about “1568200491” NPI (MAKINNA SERRATA) exists in 1568200491 in HTML format HTML  |  1568200491 in plain Text format TXT  |  1568200491 in PDF (Portable Document Format) PDF  |  1568200491 in an XML format XML  formats.

NPI Number : 1568200491 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1568200491",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SERRATA",
    "FirstName": "MAKINNA",
    "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": "130 COUNTY ROAD 307",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TILDEN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78072-3037",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "361-449-5596",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "130 COUNTY ROAD 307",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TILDEN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78072-3037",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "361-449-5596",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/16/2024",
    "LastUpdateDate": "07/16/2024",
    "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": "390200000X",
        "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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