{
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"FirstLineMailingAddress": "PO BOX 820345",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH RICHLAND HILLS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76182-0345",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "817-605-0993",
"FirstLinePracticeLocationAddress": "1441 N BECKLEY AVE",
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"EnumerationDate": "10/22/2008",
"LastUpdateDate": "10/22/2008",
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"AuthorizedOfficialLastName": "KANE",
"AuthorizedOfficialFirstName": "JOHN",
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"AuthorizedOfficialCredential": "PA",
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"Taxonomies": {
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"TaxonomyName": "Surgical Physician Assistant",
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"LicenseNumberStateCode": "TX",
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}
},
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}
}
}
}