{
"Npi": {
"NPI": "1134452741",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "AFFINITY DISTRIBUTION, INC",
"ParentOrgTIN": null,
"OrgName": "AFFINITY DISTRIBUTION, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5109 82ND ST",
"SecondLineMailingAddress": "STE 7-1140",
"MailingAddressCityName": "LUBBOCK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "79424-3028",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "806-771-0335",
"MailingAddressFaxNumber": "806-771-3194",
"FirstLinePracticeLocationAddress": "11496 LUNA RD",
"SecondLinePracticeLocationAddress": "STE 300",
"PracticeLocationAddressCityName": "DALLAS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75234-9425",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-556-0335",
"PracticeLocationAddressFaxNumber": "972-556-0727",
"EnumerationDate": "09/14/2009",
"LastUpdateDate": "10/26/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HINES",
"AuthorizedOfficialFirstName": "AUBREY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "806-771-0335",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": "990887",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}