{
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"FirstLineMailingAddress": "715 DISCOVERY BLVD",
"SecondLineMailingAddress": "SUITE 111 BLDG. 1",
"MailingAddressCityName": "CEDAR PARK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78613-2287",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "512-260-2100",
"MailingAddressFaxNumber": "512-260-2102",
"FirstLinePracticeLocationAddress": "715 DISCOVERY BLVD",
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"PracticeLocationAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": "512-260-2102",
"EnumerationDate": "06/26/2006",
"LastUpdateDate": "05/25/2010",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOUGHER",
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"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "512-260-2100",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Optometrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}