{
"Npi": {
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OPTIMAL EYE CARE CENTER, L.L.C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "809 SUMMER BREEZE DR APT 305",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BATON ROUGE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70810-6197",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "225-570-2753",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "20103 OLD SCENIC HWY STE 2B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ZACHARY",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70791",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "225-570-2753",
"PracticeLocationAddressFaxNumber": "225-570-2758",
"EnumerationDate": "06/14/2018",
"LastUpdateDate": "07/10/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TRAN",
"AuthorizedOfficialFirstName": "PHONG",
"AuthorizedOfficialMiddleName": "QUOC",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "337-251-6018",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "1629662T",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}