{
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"OrgName": "ARLINGTON NEONATAL INTENSIVE CARE PA",
"LastName": null,
"FirstName": null,
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"FirstLineMailingAddress": "PO BOX 120967",
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"MailingAddressCityName": "ARLINGTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76012-0967",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": "817-548-6173",
"FirstLinePracticeLocationAddress": "800 W RANDOL MILL RD",
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"PracticeLocationAddressCityName": "ARLINGTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76012-2504",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-548-6514",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/29/2008",
"LastUpdateDate": "01/29/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TISDELL",
"AuthorizedOfficialFirstName": "SCOTT",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "817-548-6514",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Specialist",
"LicenseNumber": "G3859",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}