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1578939997 NPI number — MIER SUN LASTRA PHYSICAL THERAPIST

NPI Number: 1578939997
Health Care Provider/Practitioner: MIER SUN LASTRA PHYSICAL THERAPIST

Information about “1578939997” NPI (MIER SUN LASTRA PHYSICAL THERAPIST) exists in 1578939997 in HTML format HTML  |  1578939997 in plain Text format TXT  |  1578939997 in PDF (Portable Document Format) PDF  |  1578939997 in an XML format XML  formats.

NPI Number : 1578939997 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578939997",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LASTRA",
    "FirstName": "MIER",
    "MiddleName": "SUN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "PHYSICAL THERAPIST",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SUN",
    "OtherFirstName": "MIER",
    "OtherMiddleName": "CANOY",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "PHYSICAL THERAPIST",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1402 HUMMINGBIRD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN ANTONIO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78245-4471",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "713-377-8981",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "9922 STATE HIGHWAY 151",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN ANTONIO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78251",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "210-572-9821",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/19/2015",
    "LastUpdateDate": "08/17/2018",
    "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": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "1272953",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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