NPI Code Detail JSON Logo

1912538547 NPI number — RUTHIE LEE STARK - REDMAN LCDC

NPI Number: 1912538547
Health Care Provider/Practitioner: RUTHIE LEE STARK - REDMAN LCDC

Information about “1912538547” NPI (RUTHIE LEE STARK - REDMAN LCDC) exists in 1912538547 in HTML format HTML  |  1912538547 in plain Text format TXT  |  1912538547 in PDF (Portable Document Format) PDF  |  1912538547 in an XML format XML  formats.

NPI Number : 1912538547 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1912538547",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STARK - REDMAN",
    "FirstName": "RUTHIE",
    "MiddleName": "LEE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCDC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9001 GLACIER AVE APT 226",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TEXAS CITY",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77591-3017",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "440-231-7096",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1100 NASA PWKY",
    "SecondLinePracticeLocationAddress": "SUITE 201 A",
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77598-7759",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "281-904-6512",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/02/2020",
    "LastUpdateDate": "07/24/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "14743",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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