{
"Npi": {
"NPI": "1326711516",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UNIVERSITY OF TEXAS HEALTH SCIENCE",
"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": "ONE UNIVERSITY BLVD., SPH BUILDING",
"SecondLineMailingAddress": "S-1.330",
"MailingAddressCityName": "BROWNSVILLE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78520-4936",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "956-755-0637",
"MailingAddressFaxNumber": "956-755-0606",
"FirstLinePracticeLocationAddress": "780 RINGGOLD RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BROWNSVILLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78520-4936",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "956-755-0637",
"PracticeLocationAddressFaxNumber": "956-755-0606",
"EnumerationDate": "07/26/2021",
"LastUpdateDate": "09/28/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DILLON",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "KEVIN",
"AuthorizedOfficialTitle": "SR. EXECUTIVE VP, COO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MBA, CPA",
"AuthorizedOfficialTelephoneNumber": "713-500-3535",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}