{
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"FirstLineMailingAddress": "1718 RICHMOND RD",
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"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75503-2415",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "903-838-5883",
"MailingAddressFaxNumber": "903-223-9075",
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"PracticeLocationAddressCityName": "TEXARKANA",
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"PracticeLocationAddressFaxNumber": "903-223-9075",
"EnumerationDate": "10/17/2013",
"LastUpdateDate": "08/19/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCDOUGAL",
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"AuthorizedOfficialMiddleName": "ADAMS",
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"AuthorizedOfficialCredential": "DC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": "11844",
"LicenseNumberStateCode": "TX",
"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."
}
}
}
}