{
"Npi": {
"NPI": "1619181021",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTH TEXAS DISPENSERS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1421 N ELM",
"SecondLineMailingAddress": "#105",
"MailingAddressCityName": "DENTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76201",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "940-387-9574",
"MailingAddressFaxNumber": "940-387-5502",
"FirstLinePracticeLocationAddress": "1421 N ELM",
"SecondLinePracticeLocationAddress": "#105",
"PracticeLocationAddressCityName": "DENTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76201",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "940-387-9574",
"PracticeLocationAddressFaxNumber": "940-387-5502",
"EnumerationDate": "05/09/2007",
"LastUpdateDate": "08/19/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LARDIZABAL",
"AuthorizedOfficialFirstName": "JOE",
"AuthorizedOfficialMiddleName": "B",
"AuthorizedOfficialTitle": "OWNER HEARING AID SPECIALIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BC HIS ACA BOARD CER",
"AuthorizedOfficialTelephoneNumber": "940-387-9574",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "50053",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}