NPI Code Detail JSON Logo

1720890452 NPI number — TEEKEES CLINIC

NPI Number: 1720890452
Health Care Provider/Practitioner: TEEKEES CLINIC

Information about “1720890452” NPI (TEEKEES CLINIC) exists in 1720890452 in HTML format HTML  |  1720890452 in plain Text format TXT  |  1720890452 in PDF (Portable Document Format) PDF  |  1720890452 in an XML format XML  formats.

NPI Number : 1720890452 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720890452",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "TEEKEES CLINIC",
    "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": "2260 E LOHMAN AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAS CRUCES",
    "MailingAddressStateName": "NM",
    "MailingAddressPostalCode": "88001-8490",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "575-215-3227",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "195 MORRISON DRIVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOSQUE FARMS",
    "PracticeLocationAddressStateName": "NM",
    "PracticeLocationAddressPostalCode": "87068",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "575-215-3227",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/21/2025",
    "LastUpdateDate": "01/21/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MEDINA",
    "AuthorizedOfficialFirstName": "LAURA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "SERVICES DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "915-208-6037",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LP0808X",
        "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.