{
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"FirstLineMailingAddress": "1635 ELDRIDGE PKWY",
"SecondLineMailingAddress": "SUITE 360",
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"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77077-2153",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-531-9400",
"MailingAddressFaxNumber": "281-531-9455",
"FirstLinePracticeLocationAddress": "1635 ELDRIDGE PKWY",
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"PracticeLocationAddressFaxNumber": "281-531-9455",
"EnumerationDate": "06/04/2007",
"LastUpdateDate": "06/21/2018",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TON",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Optometrist",
"LicenseNumber": "05930TG",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}