{
"Npi": {
"NPI": "1770955239",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "M & A PHARMACY LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4321 MULLIGAN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MANSFIELD",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76063-3480",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-641-4051",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8200 MATLOCK ROAD, STE 150",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ARLINGTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76002",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "682-222-7830",
"PracticeLocationAddressFaxNumber": "682-222-7829",
"EnumerationDate": "10/23/2015",
"LastUpdateDate": "12/30/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEE",
"AuthorizedOfficialFirstName": "YALING",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.PH",
"AuthorizedOfficialTelephoneNumber": "214-641-4051",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "30262",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}