{
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"EIN": null,
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "EXCELLENT EYE CARE P.A.",
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"NamePrefix": null,
"NameSuffix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2665 MARKET CENTER DR STE 100",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCKWALL",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75032-6563",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-772-9659",
"MailingAddressFaxNumber": "972-772-3120",
"FirstLinePracticeLocationAddress": "2665 MARKET CENTER DR STE 100",
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"PracticeLocationAddressCityName": "ROCKWALL",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-772-9659",
"PracticeLocationAddressFaxNumber": "972-772-3120",
"EnumerationDate": "11/21/2013",
"LastUpdateDate": "11/21/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NGUYEN",
"AuthorizedOfficialFirstName": "MONICA",
"AuthorizedOfficialMiddleName": "QUYNH",
"AuthorizedOfficialTitle": "OPTOMETRIST",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "972-772-9659",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "6813T",
"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."
}
}
}
}