{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WILLS OPTICAL OF GARLAND INC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3034 BROADWAY BLVD",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "GARLAND",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75041",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-271-3930",
"MailingAddressFaxNumber": "972-840-6680",
"FirstLinePracticeLocationAddress": "3034 BROADWAY BLVD",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "GARLAND",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-271-3930",
"PracticeLocationAddressFaxNumber": "972-840-6680",
"EnumerationDate": "10/17/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILLS",
"AuthorizedOfficialFirstName": "VICKIE",
"AuthorizedOfficialMiddleName": "ROSANNE",
"AuthorizedOfficialTitle": "OWNER VP",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "972-271-3930",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}