{
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"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "Y",
"ParentOrgLBN": "ALBUQUERQUE ASSOCIATES OF OPTOMETRY",
"ParentOrgTIN": null,
"OrgName": "ALBUQUERQUE ASSOCIATES OF OPTOMETRY",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "112 HERMOSA DR SE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBUQUERQUE",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "87108-2610",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "505-265-3443",
"MailingAddressFaxNumber": "505-265-7006",
"FirstLinePracticeLocationAddress": "112 HERMOSA DR SE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALBUQUERQUE",
"PracticeLocationAddressStateName": "NM",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "505-265-3443",
"PracticeLocationAddressFaxNumber": "505-265-7006",
"EnumerationDate": "01/09/2008",
"LastUpdateDate": "01/09/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PURO",
"AuthorizedOfficialFirstName": "KAZUKO",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "CO-OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "505-265-3443",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "2326",
"LicenseNumberStateCode": "NM",
"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."
}
}
}
}