{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "CLEAR EYES PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9210 SERENE CREEK DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN ANTONIO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78230-4038",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "210-399-2020",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1336 SW MILITARY DR",
"SecondLinePracticeLocationAddress": "SUITE 3",
"PracticeLocationAddressCityName": "SAN ANTONIO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78221-1575",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "210-399-2020",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/27/2013",
"LastUpdateDate": "03/04/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RICHARDSON",
"AuthorizedOfficialFirstName": "RONALD",
"AuthorizedOfficialMiddleName": "WAYNE",
"AuthorizedOfficialTitle": "C.E.O.",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "210-399-2020",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "7506TG",
"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."
}
}
}
}