{
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"OrgName": "LORENZO K. SAMPSON, M.D., P.A.",
"LastName": null,
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"FirstLineMailingAddress": "PO BOX 5617",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KINGWOOD",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77325-5617",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-592-6300",
"MailingAddressFaxNumber": "281-592-6305",
"FirstLinePracticeLocationAddress": "22999 HIGHWAY 59 N",
"SecondLinePracticeLocationAddress": "SUITE 290 B",
"PracticeLocationAddressCityName": "KINGWOOD",
"PracticeLocationAddressStateName": "TX",
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"EnumerationDate": "10/02/2013",
"LastUpdateDate": "10/02/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SAMMPSON",
"AuthorizedOfficialFirstName": "LORENZO",
"AuthorizedOfficialMiddleName": "KEITH",
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR/ PRESIDENT",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "281-592-6300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "K8468",
"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."
}
}
}
}