{
"Npi": {
"NPI": "1477099281",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HARRELL",
"FirstName": "TYRA",
"MiddleName": "C",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "L.A.T",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CHARLES",
"OtherFirstName": "TYRA",
"OtherMiddleName": "ROCHELLE",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "L.A.T",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "19123 FOREST TRACE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUMBLE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77346-5045",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "832-419-4035",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "19123 FOREST TRACE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUMBLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77346-5045",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "832-419-4035",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/18/2017",
"LastUpdateDate": "01/18/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2255A2300X",
"TaxonomyName": "Athletic Trainer",
"LicenseNumber": "2381",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}