{
"Npi": {
"NPI": "1407009525",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GILBERT GONZALES, JR, DC, PA, DBA SOUTH TEXAS CHIROPRACTIC PAIN CENTER",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1931 NW MILITARY HWY STE 204",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN ANTONIO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78213-2144",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "210-541-8965",
"MailingAddressFaxNumber": "210-541-8964",
"FirstLinePracticeLocationAddress": "1931 NW MILITARY HWY STE 204",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN ANTONIO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78213-2144",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "210-541-8965",
"PracticeLocationAddressFaxNumber": "210-541-8964",
"EnumerationDate": "11/03/2008",
"LastUpdateDate": "11/03/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GONZALES",
"AuthorizedOfficialFirstName": "GILBERT",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/DOCTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "210-541-8965",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "7403",
"LicenseNumberStateCode": "TX",
"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."
}
}
}
}