{
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"FirstLineMailingAddress": "802 W GORE BLVD",
"SecondLineMailingAddress": null,
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "580-353-4113",
"MailingAddressFaxNumber": "580-357-3862",
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"PracticeLocationAddressFaxNumber": "580-357-3862",
"EnumerationDate": "01/16/2007",
"LastUpdateDate": "04/24/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEWELL",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPH",
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"Taxonomies": {
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{
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"PrimaryTaxonomySwitch": "N"
},
{
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},
{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}