{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "INTERNAL MEDICINE CLINIC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2843 MARTINA DR.",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FRIENDSWOOD",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77546",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "713-594-5595",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2843 MARTINA DR",
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"PracticeLocationAddressCityName": "FRIENDSWOOD",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressTelephoneNumber": "713-594-5595",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/18/2012",
"LastUpdateDate": "10/18/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIA-ZAYAS",
"AuthorizedOfficialFirstName": "ANGELES",
"AuthorizedOfficialMiddleName": null,
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "713-947-9408",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "720463",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}