{
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"NamePrefix": null,
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"FirstLineMailingAddress": "3017 S SUGAR RD",
"SecondLineMailingAddress": "SUITE G",
"MailingAddressCityName": "EDINBURG",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78539-1823",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "956-381-4012",
"MailingAddressFaxNumber": "956-381-4013",
"FirstLinePracticeLocationAddress": "3017 S SUGAR RD",
"SecondLinePracticeLocationAddress": "SUITE G",
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"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78539-1823",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "956-381-4012",
"PracticeLocationAddressFaxNumber": "956-381-4013",
"EnumerationDate": "10/24/2007",
"LastUpdateDate": "05/28/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REYES",
"AuthorizedOfficialFirstName": "ADOLFO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMSW-IPR",
"AuthorizedOfficialTelephoneNumber": "956-682-7510",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3747P1801X",
"TaxonomyName": "Personal Care Attendant",
"LicenseNumber": "010793",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}