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1790752418 NPI number — THOMAS IRVIN WASHINGTON PT, M.B.A., ATC

NPI Number: 1790752418
Health Care Provider/Practitioner: THOMAS IRVIN WASHINGTON PT, M.B.A., ATC

Information about “1790752418” NPI (THOMAS IRVIN WASHINGTON PT, M.B.A., ATC) exists in 1790752418 in HTML format HTML  |  1790752418 in plain Text format TXT  |  1790752418 in PDF (Portable Document Format) PDF  |  1790752418 in an XML format XML  formats.

NPI Number : 1790752418 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790752418",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WASHINGTON",
    "FirstName": "THOMAS",
    "MiddleName": "IRVIN",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "PT, M.B.A., ATC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "12758 CIMARRON PATH",
    "SecondLineMailingAddress": "STE 126",
    "MailingAddressCityName": "SAN ANTONIO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78249-3498",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "210-615-8844",
    "MailingAddressFaxNumber": "210-615-6959",
    "FirstLinePracticeLocationAddress": "12758 CIMARRON PATH",
    "SecondLinePracticeLocationAddress": "STE 126",
    "PracticeLocationAddressCityName": "SAN ANTONIO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78249-3498",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "210-615-8844",
    "PracticeLocationAddressFaxNumber": "210-615-6959",
    "EnumerationDate": "03/01/2006",
    "LastUpdateDate": "10/26/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "1022770",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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