{
"Npi": {
"NPI": "1396944179",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PASADENA MEDICAL PLAZA PHARMACY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1430B PASADENA BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PASADENA",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77502",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "713-429-1842",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1430B PASADENA BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PASADENA",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77502",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "713-429-1842",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/12/2007",
"LastUpdateDate": "07/12/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RODRIGUEZ",
"AuthorizedOfficialFirstName": "ANNICK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT/CEO",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "832-724-0065",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "25624",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}