{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "POTENCIANO R. GARCIA, JR. M.D., P.A.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "PO BOX 4876",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MCALLEN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78502-4876",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "956-631-5864",
"MailingAddressFaxNumber": "956-631-5880",
"FirstLinePracticeLocationAddress": "4903 N MCCOLL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MCALLEN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78504-2310",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "956-631-5864",
"PracticeLocationAddressFaxNumber": "956-631-5880",
"EnumerationDate": "01/30/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARCIA",
"AuthorizedOfficialFirstName": "POTENCIANO",
"AuthorizedOfficialMiddleName": "R.",
"AuthorizedOfficialTitle": "PHYSICIAN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "956-631-5864",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RP1001X",
"TaxonomyName": "Pulmonary Disease Physician",
"LicenseNumber": "G7214",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}