{
"Npi": {
"NPI": "1184956344",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TEXAS DURABLE MEDICAL EQUIPMENT, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "113 S COMMERCE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DILLEY",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78017-3501",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "830-965-4900",
"MailingAddressFaxNumber": "830-965-4911",
"FirstLinePracticeLocationAddress": "2298 N VETERANS BLVD",
"SecondLinePracticeLocationAddress": "SUITE 1",
"PracticeLocationAddressCityName": "EAGLE PASS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78852-4160",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "830-757-5800",
"PracticeLocationAddressFaxNumber": "830-757-5801",
"EnumerationDate": "02/12/2010",
"LastUpdateDate": "02/12/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COURSER",
"AuthorizedOfficialFirstName": "HARVEY",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "C PED",
"AuthorizedOfficialTelephoneNumber": "830-965-4900",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "332B00000X",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}