{
"Npi": {
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"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "METRAD MOBILE IMAGING",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 62686",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77205-2681",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-948-0957",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "560 KINGWOOD DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KINGWOOD",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77339-4473",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "281-948-0957",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/30/2009",
"LastUpdateDate": "06/30/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCKAY",
"AuthorizedOfficialFirstName": "MARVIN",
"AuthorizedOfficialMiddleName": "AGUSTUS",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RADIOGRAPHER",
"AuthorizedOfficialTelephoneNumber": "281-948-0957",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335V00000X",
"TaxonomyName": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
"LicenseNumber": "326685",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}