{
"Npi": {
"NPI": "1104099514",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LAREMONT",
"FirstName": "JUAN",
"MiddleName": "S.",
"NamePrefix": "MR.",
"NameSuffix": "JR.",
"Credential": "PHYSICIAN ASSISTANT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2120 N MAYS ST",
"SecondLineMailingAddress": "SUITE 450",
"MailingAddressCityName": "ROUND ROCK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78664-2192",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "512-828-4405",
"MailingAddressFaxNumber": "512-828-4412",
"FirstLinePracticeLocationAddress": "2120 N MAYS ST",
"SecondLinePracticeLocationAddress": "SUITE 450",
"PracticeLocationAddressCityName": "ROUND ROCK",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78664-2192",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "512-828-4405",
"PracticeLocationAddressFaxNumber": "512-828-4412",
"EnumerationDate": "04/07/2008",
"LastUpdateDate": "04/07/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "PA04504",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}