{
"Npi": {
"NPI": "1699733733",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAN ANGELO HEALTH CARE, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 422",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN ANGELO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76902-0422",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "325-653-1077",
"MailingAddressFaxNumber": "325-658-7035",
"FirstLinePracticeLocationAddress": "737 KNICKERBOCKER RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN ANGELO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76903-8777",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "325-653-1077",
"PracticeLocationAddressFaxNumber": "325-658-7035",
"EnumerationDate": "05/01/2006",
"LastUpdateDate": "08/09/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCDONALD",
"AuthorizedOfficialFirstName": "LYNETTE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "GENERAL MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "325-653-1077",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}