{
"Npi": {
"NPI": "1487760096",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MOLTZ",
"FirstName": "CANDACE",
"MiddleName": "C",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "MS, CCC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MOLTZ",
"OtherFirstName": "CANDY",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MS, CCC",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "2431 CLEARVIEW DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDLOTHIAN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76065-5459",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-857-0951",
"MailingAddressFaxNumber": "214-857-0999",
"FirstLinePracticeLocationAddress": "4500 S LANCASTER RD",
"SecondLinePracticeLocationAddress": "ASPS (126)",
"PracticeLocationAddressCityName": "DALLAS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75216-7167",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-857-0951",
"PracticeLocationAddressFaxNumber": "214-857-0999",
"EnumerationDate": "08/23/2006",
"LastUpdateDate": "07/08/2007",
"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": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "13344",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}