{
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"FirstLineMailingAddress": "1008 BURNETT ST",
"SecondLineMailingAddress": "PO BOX 1655",
"MailingAddressCityName": "WICHITA FALLS",
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"MailingAddressPostalCode": "76307-1655",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "940-322-6232",
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"PracticeLocationAddressCityName": "WICHITA FALLS",
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"PracticeLocationAddressTelephoneNumber": "940-322-6232",
"PracticeLocationAddressFaxNumber": "940-322-1751",
"EnumerationDate": "01/29/2007",
"LastUpdateDate": "07/21/2022",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BALCH",
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"AuthorizedOfficialTelephoneNumber": "940-696-2967",
"Taxonomies": {
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"LicenseNumber": "14",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}