{
"Npi": {
"NPI": "1568613438",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PHYSICIANS NETWORK ASSOCIATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1622 MAC DAVIS LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LUBBOCK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "79401-2625",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "806-799-1326",
"MailingAddressFaxNumber": "806-795-1294",
"FirstLinePracticeLocationAddress": "1511 PRESTON ST",
"SecondLinePracticeLocationAddress": "STISF: MEDICAL DEPARTMENT",
"PracticeLocationAddressCityName": "HOUSTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77002-2131",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "713-223-0601",
"PracticeLocationAddressFaxNumber": "713-223-9519",
"EnumerationDate": "10/09/2008",
"LastUpdateDate": "10/09/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WALKER",
"AuthorizedOfficialFirstName": "LARNYA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "REGIONAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "832-654-0055",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": "302R00000X",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}