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1780195412 NPI number — OLYMPUS PAIN AND ORTHOPEDICS

NPI Number: 1780195412
Health Care Provider/Practitioner: OLYMPUS PAIN AND ORTHOPEDICS

Information about “1780195412” NPI (OLYMPUS PAIN AND ORTHOPEDICS) exists in 1780195412 in HTML format HTML  |  1780195412 in plain Text format TXT  |  1780195412 in PDF (Portable Document Format) PDF  |  1780195412 in an XML format XML  formats.

NPI Number : 1780195412 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780195412",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "OLYMPUS PAIN AND ORTHOPEDICS",
    "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": "1001 12TH AVE STE 154",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORT WORTH",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76104-3929",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "469-998-2400",
    "MailingAddressFaxNumber": "469-998-2401",
    "FirstLinePracticeLocationAddress": "1001 12TH AVE STE 154",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORT WORTH",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76104-3929",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "469-998-2400",
    "PracticeLocationAddressFaxNumber": "469-998-2401",
    "EnumerationDate": "10/20/2017",
    "LastUpdateDate": "10/20/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ALONZO",
    "AuthorizedOfficialFirstName": "SHERRY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "469-998-2400",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207LP2900X",
        "TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
        "LicenseNumber": "Q8858",
        "LicenseNumberStateCode": "TX",
        "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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