{
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"FirstLineMailingAddress": "1004 KORY DR",
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"MailingAddressStateName": "TX",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1004 KORY DR",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/18/2015",
"LastUpdateDate": "09/18/2015",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MIDDLETON",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "3205826621",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}