{
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"FirstLineMailingAddress": "3116 PASEO",
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"MailingAddressCityName": "GRAND PRAIRIE",
"MailingAddressStateName": "TX",
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"FirstLinePracticeLocationAddress": "515 W MAYFIELD RD STE 416",
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"PracticeLocationAddressCityName": "ARLINGTON",
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"EnumerationDate": "05/23/2018",
"LastUpdateDate": "03/14/2020",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "NGO",
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"AuthorizedOfficialCredential": "FNP-BC, RNFA",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Family Nurse Practitioner",
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"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}