{
"Npi": {
"NPI": "1114121043",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOUTH TEXAS PERSONAL CARE SERVICE INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1022 E GRIFFIN PKWY",
"SecondLineMailingAddress": "SUITE 106B",
"MailingAddressCityName": "MISSION",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78572-2400",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "956-584-7600",
"MailingAddressFaxNumber": "956-584-7604",
"FirstLinePracticeLocationAddress": "1022 E GRIFFIN PKWY",
"SecondLinePracticeLocationAddress": "SUITE 106B",
"PracticeLocationAddressCityName": "MISSION",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78572-2400",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "956-584-7600",
"PracticeLocationAddressFaxNumber": "956-584-7604",
"EnumerationDate": "06/13/2007",
"LastUpdateDate": "02/05/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCDONALD",
"AuthorizedOfficialFirstName": "RITA",
"AuthorizedOfficialMiddleName": "DIANNE",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "956-584-7600",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251T00000X",
"TaxonomyName": "PACE Provider Organization",
"LicenseNumber": "009720",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3747P1801X",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}