{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "REDICLINIC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2801 VENETO CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEAGUE CITY",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77573-5006",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "701 W PARKWOOD AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FRIENDSWOOD",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77546-5405",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "281-947-0018",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/23/2012",
"LastUpdateDate": "05/13/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WYNN VELA",
"AuthorizedOfficialFirstName": "MICA",
"AuthorizedOfficialMiddleName": "MALEIGH",
"AuthorizedOfficialTitle": "FAMILY NURSE PRACTITIONER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "NP-C",
"AuthorizedOfficialTelephoneNumber": "832-632-2170",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "717330",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}