1689546962 NPI number — KALA DE LOS ANGELES MORALES LADRON DE GUEVARA DDS, MSD

NPI Number: 1689546962
Health Care Provider/Practitioner: KALA DE LOS ANGELES MORALES LADRON DE GUEVARA DDS, MSD

NPI Number : 1689546962 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689546962",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MORALES LADRON DE GUEVARA",
    "FirstName": "KALA",
    "MiddleName": "DE LOS ANGELES",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DDS, MSD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5951 SOUTH LOOP E UNIT 42",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOUSTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77033-1054",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "281-796-5658",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5951 SOUTH LOOP E UNIT 42",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77033-1054",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "281-796-5658",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/18/2025",
    "LastUpdateDate": "09/18/2025",
    "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": "1223E0200X",
        "TaxonomyName": "Endodontics",
        "LicenseNumber": "42003",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}