{
"Npi": {
"NPI": "1568696227",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DOCTORS EXPRESS OF THE TEMPLE AREA, PA",
"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": "3614 SW HK DODGEN LOOP",
"SecondLineMailingAddress": "SUITE F",
"MailingAddressCityName": "TEMPLE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76504-6806",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "254-295-0117",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3614 SW HK DODGEN LOOP",
"SecondLinePracticeLocationAddress": "SUITE F",
"PracticeLocationAddressCityName": "TEMPLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76504",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "254-295-0117",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/11/2009",
"LastUpdateDate": "07/12/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SUMMERS",
"AuthorizedOfficialFirstName": "RYUN",
"AuthorizedOfficialMiddleName": "MATTHEW",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "254-215-9789",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}