1952604662 NPI number — MONIQUE MAYO D.C./M.T.

NPI Number: 1952604662
Health Care Provider/Practitioner: MONIQUE MAYO D.C./M.T.

NPI Number : 1952604662 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952604662",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MAYO",
    "FirstName": "MONIQUE",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.C./M.T.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "104 E US HIGHWAY 80 STE 170",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORNEY",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75126-8615",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "972-357-7050",
    "MailingAddressFaxNumber": "800-249-4581",
    "FirstLinePracticeLocationAddress": "104 E US HIGHWAY 80 STE 170",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORNEY",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75126-8615",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "972-357-7050",
    "PracticeLocationAddressFaxNumber": "800-249-4581",
    "EnumerationDate": "12/20/2010",
    "LastUpdateDate": "12/28/2023",
    "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": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": "033885",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "111N00000X",
          "TaxonomyName": "Chiropractor",
          "LicenseNumber": "14468",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}