{
"Npi": {
"NPI": "1588190904",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "TEXAS HEALTH HUGULEY, INC",
"ParentOrgTIN": null,
"OrgName": "TEXAS HEALTH HUGULEY SURGERY CENTER, LLC",
"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": "12001 SOUTH FWY",
"SecondLineMailingAddress": "SUITE 101",
"MailingAddressCityName": "BURLESON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76028-7208",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-615-4400",
"MailingAddressFaxNumber": "817-615-4420",
"FirstLinePracticeLocationAddress": "12001 SOUTH FWY",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "BURLESON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76028-7208",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-615-4400",
"PracticeLocationAddressFaxNumber": "817-615-4420",
"EnumerationDate": "05/04/2017",
"LastUpdateDate": "11/20/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JOHNSON",
"AuthorizedOfficialFirstName": "PENNY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT, CEO TEXAS HEALTH HUGULEY",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "817-551-2704",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}