{
"Npi": {
"NPI": "1639206006",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MITSCHKE",
"FirstName": "MICHAEL",
"MiddleName": "CHARLES",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D. FACC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MITSCHKE",
"OtherFirstName": "MICHAEL",
"OtherMiddleName": "CHARLES",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "MD FACC",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "915 GESSNER RD",
"SecondLineMailingAddress": "SUITE 900",
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77024-2527",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "713-464-6006",
"MailingAddressFaxNumber": "713-464-1272",
"FirstLinePracticeLocationAddress": "915 GESSNER RD",
"SecondLinePracticeLocationAddress": "SUITE 900",
"PracticeLocationAddressCityName": "HOUSTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77024-2527",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "713-464-6006",
"PracticeLocationAddressFaxNumber": "713-464-1272",
"EnumerationDate": "02/27/2007",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RC0000X",
"TaxonomyName": "Cardiovascular Disease Physician",
"LicenseNumber": "H8264",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}