{
"Npi": {
"NPI": "1407023518",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WEST TEXAS LTC PARTNERS, INC.",
"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": "1915 GREENWOOD ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN ANGELO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76901-1112",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "325-942-0677",
"MailingAddressFaxNumber": "325-942-1331",
"FirstLinePracticeLocationAddress": "1915 GREENWOOD ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN ANGELO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76901-1112",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "325-942-0677",
"PracticeLocationAddressFaxNumber": "325-942-1331",
"EnumerationDate": "05/08/2008",
"LastUpdateDate": "01/20/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NICHOLSON",
"AuthorizedOfficialFirstName": "LOUIS",
"AuthorizedOfficialMiddleName": "FREDERICK",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "III",
"AuthorizedOfficialCredential": "LNFA",
"AuthorizedOfficialTelephoneNumber": "832-489-9944",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "001016152",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "676068",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "5236",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "124667",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}