{
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"EIN": null,
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"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "825 N MCDONALD ST SUITE 130",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MCKINNEY",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75069-2141",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-548-5503",
"MailingAddressFaxNumber": "972-548-4441",
"FirstLinePracticeLocationAddress": "825 N MCDONALD ST SUITE 130",
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"PracticeLocationAddressCityName": "MCKINNEY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-548-5503",
"PracticeLocationAddressFaxNumber": "972-548-4441",
"EnumerationDate": "08/31/2006",
"LastUpdateDate": "12/15/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BLAIR",
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"AuthorizedOfficialTitle": "HEALTH CARE ADMINISTRATOR",
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"AuthorizedOfficialCredential": "R.N.",
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"Taxonomies": {
"Taxonomy": {
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"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}