{
"Npi": {
"NPI": "1386878932",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PRESTONWOOD IMAGING, 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": "5729 LEBANON RD",
"SecondLineMailingAddress": "SUITE 144327",
"MailingAddressCityName": "FRISCO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75034-7260",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-312-9944",
"MailingAddressFaxNumber": "972-312-9962",
"FirstLinePracticeLocationAddress": "5729 LEBANON RD",
"SecondLinePracticeLocationAddress": "SUITE 144327",
"PracticeLocationAddressCityName": "FRISCO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75034-7260",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-312-9944",
"PracticeLocationAddressFaxNumber": "972-312-9962",
"EnumerationDate": "05/12/2009",
"LastUpdateDate": "05/12/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CLIFFORD",
"AuthorizedOfficialFirstName": "PHILLIP",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "MANAGING PARTNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "214-618-4674",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}