{
"Npi": {
"NPI": "1275723249",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BEVERLY GUILLORY LEWIS MD, PA",
"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": "1228 N LOGAN ST",
"SecondLineMailingAddress": "STE 200",
"MailingAddressCityName": "TEXAS CITY",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77590-5171",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "409-945-0810",
"MailingAddressFaxNumber": "409-945-6678",
"FirstLinePracticeLocationAddress": "1021 61ST ST",
"SecondLinePracticeLocationAddress": "#210",
"PracticeLocationAddressCityName": "GALVESTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77550-0000",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "409-740-2700",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/26/2007",
"LastUpdateDate": "04/03/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WATKINS",
"AuthorizedOfficialFirstName": "DENNICE",
"AuthorizedOfficialMiddleName": "M.",
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "409-945-0810",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "F4211",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}