{
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"FirstLineMailingAddress": "101 HOSPTIAL LOOP NE",
"SecondLineMailingAddress": "SUITE 115",
"MailingAddressCityName": "ALBUQUERQUE",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "87109-2129",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "505-883-6600",
"MailingAddressFaxNumber": "505-883-0023",
"FirstLinePracticeLocationAddress": "2312 WESTERN TRAILS",
"SecondLinePracticeLocationAddress": "SUITE 103",
"PracticeLocationAddressCityName": "AUSTIN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78745-1642",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "512-382-0773",
"PracticeLocationAddressFaxNumber": "512-382-0072",
"EnumerationDate": "10/24/2012",
"LastUpdateDate": "10/24/2012",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DRURY",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "DPM",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213E00000X",
"TaxonomyName": "Podiatrist",
"LicenseNumber": "1876",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}