{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "AMANDEEP BASRAI PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "225 EXCHANGE ST",
"SecondLineMailingAddress": "STE. D",
"MailingAddressCityName": "BURLESON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76028-4588",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1011 N HIGHWAY 77",
"SecondLinePracticeLocationAddress": "STE. 104",
"PracticeLocationAddressCityName": "WAXAHACHIE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75165-1399",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-426-9337",
"PracticeLocationAddressFaxNumber": "817-426-9336",
"EnumerationDate": "03/25/2010",
"LastUpdateDate": "03/25/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BASRAI",
"AuthorizedOfficialFirstName": "AMANDEEP",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/DENITIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "817-426-9337",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "25103",
"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."
}
}
}
}