{
"Npi": {
"NPI": "1255528915",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "WAXAHACHIE WOMEN'S SURGERY PAVILION, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": "6",
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1505 W JEFFERSON ST STE 120",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WAXAHACHIE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75165-2200",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1324 BROWN ST STE 600",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WAXAHACHIE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75165-1426",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-973-6277",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/26/2007",
"LastUpdateDate": "09/26/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHRISTIAN",
"AuthorizedOfficialFirstName": "MARILYN",
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"AuthorizedOfficialTitle": "COO",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "713-554-7503",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "007799",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}