NPI Code Detail JSON Logo

1588650337 NPI number — NEW LIFE PROSTHETICS AND ORTHOTICS

NPI Number: 1588650337
Health Care Provider/Practitioner: NEW LIFE PROSTHETICS AND ORTHOTICS

Information about “1588650337” NPI (NEW LIFE PROSTHETICS AND ORTHOTICS) exists in 1588650337 in HTML format HTML  |  1588650337 in plain Text format TXT  |  1588650337 in PDF (Portable Document Format) PDF  |  1588650337 in an XML format XML  formats.

NPI Number : 1588650337 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1588650337",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NEW LIFE PROSTHETICS AND ORTHOTICS",
    "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": "2013 WELLS BRANCH PKWY",
    "SecondLineMailingAddress": "STE 207",
    "MailingAddressCityName": "AUSTIN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78728-6900",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "512-252-7177",
    "MailingAddressFaxNumber": "512-252-7156",
    "FirstLinePracticeLocationAddress": "2013 WELLS BRANCH PKWY",
    "SecondLinePracticeLocationAddress": "STE 207",
    "PracticeLocationAddressCityName": "AUSTIN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78728-6900",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-252-7177",
    "PracticeLocationAddressFaxNumber": "512-252-7156",
    "EnumerationDate": "09/26/2005",
    "LastUpdateDate": "04/23/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ATHA",
    "AuthorizedOfficialFirstName": "SCOTT",
    "AuthorizedOfficialMiddleName": "BOWDEN",
    "AuthorizedOfficialTitle": "ORTHOTIST PROSTHETIST MANAGER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LPO",
    "AuthorizedOfficialTelephoneNumber": "512-252-7177",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "335E00000X",
        "TaxonomyName": "Prosthetic/Orthotic Supplier",
        "LicenseNumber": "2",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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