{
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"EIN": null,
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"IsOrgSubpart": "N",
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"LastName": null,
"FirstName": null,
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"NamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "14703 EAGLE VISTA DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77077-5394",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "14703 EAGLE VISTA DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOUSTON",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "281-249-7130",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/02/2021",
"LastUpdateDate": "02/02/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MALEJAN",
"AuthorizedOfficialFirstName": "KRISTEN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "RESIDENT LIFE DIRECTOR",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "281-249-7271",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}