{
"Npi": {
"NPI": "1255972972",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CY PAIN AND REHAB PLLC",
"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": "4541 N JOSEY LN STE 230",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CARROLLTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75010-4781",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-506-0904",
"MailingAddressFaxNumber": "888-366-2632",
"FirstLinePracticeLocationAddress": "4541 N JOSEY LN STE 230",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CARROLLTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75010-4781",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-506-0904",
"PracticeLocationAddressFaxNumber": "888-366-2632",
"EnumerationDate": "10/03/2019",
"LastUpdateDate": "03/19/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "UONG",
"AuthorizedOfficialFirstName": "CHAU",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHYSICIAN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DO",
"AuthorizedOfficialTelephoneNumber": "214-641-5777",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QP3300X",
"TaxonomyName": "Pain Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "261QR0400X",
"TaxonomyName": "Rehabilitation Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}