{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "LONE STAR CIRCLE OF CARE",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3102 MINTHORN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KILLEEN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76542-1932",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "254-268-1385",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3102 MINTHORN DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KILLEEN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76542-1932",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "254-268-1385",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/25/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ESPAILLAT",
"AuthorizedOfficialFirstName": "FERMINA",
"AuthorizedOfficialMiddleName": "AMARILIS",
"AuthorizedOfficialTitle": "OB CASE MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "512-828-3300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "171M00000X",
"TaxonomyName": "Case Manager/Care Coordinator",
"LicenseNumber": "628558",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}