{
"Npi": {
"NPI": "1871922310",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHAW PEDIATRICS PA",
"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": "240 E EVERGREEN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHERMAN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75090-5056",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "903-957-7429",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "240 E EVERGREEN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SHERMAN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75090-5056",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "903-957-7429",
"PracticeLocationAddressFaxNumber": "903-957-7424",
"EnumerationDate": "11/05/2013",
"LastUpdateDate": "11/05/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHAW",
"AuthorizedOfficialFirstName": "CLYDE",
"AuthorizedOfficialMiddleName": "EDWARD",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "903-957-7429",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "E2856",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}