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1710462601 NPI number — ABRAZOS PEDIATRIC THERAPY PLLC

NPI Number: 1710462601
Health Care Provider/Practitioner: ABRAZOS PEDIATRIC THERAPY PLLC

Information about “1710462601” NPI (ABRAZOS PEDIATRIC THERAPY PLLC) exists in 1710462601 in HTML format HTML  |  1710462601 in plain Text format TXT  |  1710462601 in PDF (Portable Document Format) PDF  |  1710462601 in an XML format XML  formats.

NPI Number : 1710462601 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710462601",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ABRAZOS PEDIATRIC THERAPY PLLC",
    "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": "4849 N MESA ST STE 201",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EL PASO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "79912-5919",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "915-351-6600",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7144 ALAMEDA AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EL PASO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "79915-3502",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "915-990-8683",
    "PracticeLocationAddressFaxNumber": "915-444-5908",
    "EnumerationDate": "09/26/2018",
    "LastUpdateDate": "01/09/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MARTINEZ",
    "AuthorizedOfficialFirstName": "ANA",
    "AuthorizedOfficialMiddleName": "L",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "CCC-SLP",
    "AuthorizedOfficialTelephoneNumber": "915-351-6600",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261Q00000X",
          "TaxonomyName": "Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QH0700X",
          "TaxonomyName": "Hearing and Speech Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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