{
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"EIN": null,
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"ParentOrgLBN": null,
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"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "5001 S COOPER ST STE 206",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ARLINGTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76017-5993",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-460-4400",
"MailingAddressFaxNumber": "884-887-8918",
"FirstLinePracticeLocationAddress": "5001 S COOPER ST STE 206",
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"PracticeLocationAddressCityName": "ARLINGTON",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-460-4400",
"PracticeLocationAddressFaxNumber": "888-488-7891",
"EnumerationDate": "07/22/2010",
"LastUpdateDate": "10/05/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PARK",
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"AuthorizedOfficialTitle": "PHARMACIST-IN-CHARGE",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "817-460-4400",
"Taxonomies": {
"Taxonomy": [
{
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}