{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UNIVERSITY OF TEXAS MEDICAL BRANCH",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"FirstLineMailingAddress": "301 UNIVERSITY BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GALVESTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77555-5302",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "409-772-1011",
"MailingAddressFaxNumber": "409-772-5052",
"FirstLinePracticeLocationAddress": "301 UNIVERSITY BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GALVESTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77555-5302",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "409-772-1011",
"PracticeLocationAddressFaxNumber": "409-772-5052",
"EnumerationDate": "07/17/2015",
"LastUpdateDate": "07/17/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CALLENDER",
"AuthorizedOfficialFirstName": "DAVID",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "MD, MBA, FACS",
"AuthorizedOfficialTelephoneNumber": "409-772-1011",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": "AP117487",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}