{
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"FirstLineMailingAddress": "7238 RUBY PALM PASS",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN ANTONIO",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "210-257-0675",
"MailingAddressFaxNumber": "210-695-7036",
"FirstLinePracticeLocationAddress": "105 S SEGUIN RD STE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CONVERSE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "210-257-0675",
"PracticeLocationAddressFaxNumber": "210-695-7036",
"EnumerationDate": "09/03/2026",
"LastUpdateDate": "09/03/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MENDOZA GUTIERREZ",
"AuthorizedOfficialFirstName": "YUNEIDYS",
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"AuthorizedOfficialTitle": "FNP-BC",
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"AuthorizedOfficialCredential": "FNP-BC",
"AuthorizedOfficialTelephoneNumber": "210-876-8577",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}