{
"Npi": {
"NPI": "1609996453",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KARA VEL SHOE STORE INC",
"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": "5525 BURNET RD",
"SecondLineMailingAddress": "SUITE 1",
"MailingAddressCityName": "AUSTIN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78756-1603",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "512-459-7603",
"MailingAddressFaxNumber": "512-459-5243",
"FirstLinePracticeLocationAddress": "5525 BURNET RD",
"SecondLinePracticeLocationAddress": "SUITE 1",
"PracticeLocationAddressCityName": "AUSTIN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78756-1603",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "512-459-7603",
"PracticeLocationAddressFaxNumber": "512-459-5243",
"EnumerationDate": "03/29/2007",
"LastUpdateDate": "07/18/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAVEL",
"AuthorizedOfficialFirstName": "RICK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CERTIFIED PEDORTHIST",
"AuthorizedOfficialTelephoneNumber": "512-459-7603",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BC3200X",
"TaxonomyName": "Customized Equipment (DME)",
"LicenseNumber": "332BC3200X",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}