{
"Npi": {
"NPI": "1407879489",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MAYEN NUNEZ",
"FirstName": "JOSE",
"MiddleName": "ISAIAS",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MAYEN",
"OtherFirstName": "JOSE",
"OtherMiddleName": "I",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": "JR.",
"OtherCredential": "MD",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "PO BOX 4897",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77210-4897",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-332-1075",
"MailingAddressFaxNumber": "281-332-7012",
"FirstLinePracticeLocationAddress": "561 MEDICAL CENTER BLVD STE C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WEBSTER",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77598-4240",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "281-332-1075",
"PracticeLocationAddressFaxNumber": "281-332-7012",
"EnumerationDate": "07/25/2006",
"LastUpdateDate": "11/13/2014",
"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": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "J4912",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}