{
"Npi": {
"NPI": "1639340110",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROBERT J. COOLBAUGH, DC, DBA LUBBOCK ACCIDENT AND INJURY REHAB",
"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": "2318 50TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LUBBOCK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "79412-2502",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "806-780-1258",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2318 50TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LUBBOCK",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "79412-2502",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "806-780-1258",
"PracticeLocationAddressFaxNumber": "806-780-1261",
"EnumerationDate": "03/12/2008",
"LastUpdateDate": "06/16/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COOLBAUGH",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "806-780-1258",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "F008104",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}