{
"Npi": {
"NPI": "1760959860",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PANCHO INDEPENDENT PHARMACY INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1108 WISHING TREE LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KELLER",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76248-5272",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "713-253-5115",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "790 KELLER PKWY STE 1505",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KELLER",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76248-2403",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "713-253-5115",
"PracticeLocationAddressFaxNumber": "817-379-2677",
"EnumerationDate": "10/26/2018",
"LastUpdateDate": "10/26/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NJIE",
"AuthorizedOfficialFirstName": "FRANCIS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHAR-D",
"AuthorizedOfficialTelephoneNumber": "713-253-5115",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332900000X",
"TaxonomyName": "Non-Pharmacy Dispensing Site",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}