{
"Npi": {
"NPI": "1629173000",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DR NINH PHAM OD AND ASSOCIATES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3919 FAIRMONT PKWY APT 220",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PASADENA",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77504-3063",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-542-9350",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9025 SPENCER HWY",
"SecondLinePracticeLocationAddress": "DR. NINH PHAM'S OPTOMETRY OFFICE",
"PracticeLocationAddressCityName": "LA PORTE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77571-3870",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "281-542-9350",
"PracticeLocationAddressFaxNumber": "281-542-9355",
"EnumerationDate": "09/13/2006",
"LastUpdateDate": "07/21/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PHAM",
"AuthorizedOfficialFirstName": "NINH",
"AuthorizedOfficialMiddleName": "XUAN",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "281-542-9350",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "6245TG",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}