{
"Npi": {
"NPI": "1366002255",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TAYLOR FAMILY DIAGNOSTICS LLC",
"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": "1806 HUMBLE PLACE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUMBLE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77338-5277",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-667-4974",
"MailingAddressFaxNumber": "214-594-9559",
"FirstLinePracticeLocationAddress": "1806 HUMBLE PLACE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUMBLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77338-5277",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "844-212-5321",
"PracticeLocationAddressFaxNumber": "214-594-9559",
"EnumerationDate": "06/13/2019",
"LastUpdateDate": "01/28/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TAYLOR",
"AuthorizedOfficialFirstName": "JILL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DO",
"AuthorizedOfficialTelephoneNumber": "281-667-4974",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "246ZE0500X",
"TaxonomyName": "EEG Specialist/Technologist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "246ZE0600X",
"TaxonomyName": "Electroneurodiagnostic Specialist/Technologist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2472E0500X",
"TaxonomyName": "EEG Technician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "293D00000X",
"TaxonomyName": "Physiological Laboratory",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}