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1710284542 NPI number — LONE STAR CIRCLE OF CARE

NPI Number: 1710284542
Health Care Provider/Practitioner: LONE STAR CIRCLE OF CARE

Information about “1710284542” NPI (LONE STAR CIRCLE OF CARE) exists in 1710284542 in HTML format HTML  |  1710284542 in plain Text format TXT  |  1710284542 in PDF (Portable Document Format) PDF  |  1710284542 in an XML format XML  formats.

NPI Number : 1710284542 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710284542",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "LONE STAR CIRCLE OF CARE",
    "ParentOrgTIN": null,
    "OrgName": "LONE STAR CIRCLE OF CARE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "205 E UNIVERSITY AVE",
    "SecondLineMailingAddress": "SUITE 200",
    "MailingAddressCityName": "GEORGETOWN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78626-6814",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "512-868-1124",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "200 NOLA RUTH BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HARKER HEIGHTS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76548-6074",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "877-800-5722",
    "PracticeLocationAddressFaxNumber": "254-698-1673",
    "EnumerationDate": "02/14/2011",
    "LastUpdateDate": "01/30/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CALVIN",
    "AuthorizedOfficialFirstName": "JONATHAN",
    "AuthorizedOfficialMiddleName": "DAVID",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "512-994-1933",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QF0400X",
        "TaxonomyName": "Federally Qualified Health Center (FQHC)",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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