{
"Npi": {
"NPI": "1912375775",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THE AUSTIN DIAGNOSTIC CLINIC ASSOCIATION",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 55379",
"SecondLineMailingAddress": "DEPT # 10100 C/O PHARMAPOINT",
"MailingAddressCityName": "BIRMINGHAM",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35255-5379",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "205-795-8800",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "12221 N MOPAC EXPY",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "AUSTIN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78758-2401",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "512-901-4797",
"PracticeLocationAddressFaxNumber": "512-901-3967",
"EnumerationDate": "09/10/2015",
"LastUpdateDate": "09/10/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LANCASTER",
"AuthorizedOfficialFirstName": "BLAKE",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "PHARMACY MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "205-795-8800",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "30073",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}