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1639590482 NPI number — VIVIN EARL MERRITT JR. M. D., F. A. C. S.

NPI Number: 1639590482
Health Care Provider/Practitioner: VIVIN EARL MERRITT JR. M. D., F. A. C. S.

Information about “1639590482” NPI (VIVIN EARL MERRITT JR. M. D., F. A. C. S.) exists in 1639590482 in HTML format HTML  |  1639590482 in plain Text format TXT  |  1639590482 in PDF (Portable Document Format) PDF  |  1639590482 in an XML format XML  formats.

NPI Number : 1639590482 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639590482",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MERRITT",
    "FirstName": "VIVIN",
    "MiddleName": "EARL",
    "NamePrefix": "DR.",
    "NameSuffix": "JR.",
    "Credential": "M. D., F. A. C. S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "190 MERRITT RANCH RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HARPER",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78631-8001",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "325-446-4866",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "190 MERRITT RANCH RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HARPER",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78631-8001",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "325-446-4866",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/20/2013",
    "LastUpdateDate": "12/20/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208600000X",
        "TaxonomyName": "Surgery Physician",
        "LicenseNumber": "E 1055",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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