NPI Code Detail JSON Logo

1871221002 NPI number — REAL WELL THERAPY, PLLC

NPI Number: 1871221002
Health Care Provider/Practitioner: REAL WELL THERAPY, PLLC

Information about “1871221002” NPI (REAL WELL THERAPY, PLLC) exists in 1871221002 in HTML format HTML  |  1871221002 in plain Text format TXT  |  1871221002 in PDF (Portable Document Format) PDF  |  1871221002 in an XML format XML  formats.

NPI Number : 1871221002 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871221002",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "REAL WELL 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": "702 E NEW BRAUNFELS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SEGUIN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78155-2835",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3625 MENCHACA RD STE 202",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "AUSTIN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78704-5912",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "713-870-4059",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/15/2022",
    "LastUpdateDate": "08/15/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "OSBORN",
    "AuthorizedOfficialFirstName": "LISA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER/THERAPIST",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "713-870-4059",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QM0801X",
        "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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