{
"Npi": {
"NPI": "1972052413",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "QUALITY CARE HEALTH CLINICS OF NORTH TEXAS PLLC",
"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": "465 WALES CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COPPELL",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75019-5140",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-454-3637",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "333 N SHILOH RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GARLAND",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75042-6680",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-454-3637",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/26/2016",
"LastUpdateDate": "06/25/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OSUJI",
"AuthorizedOfficialFirstName": "TOCHI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "214-454-3637",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "K6669",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}