{
"Npi": {
"NPI": "1780980862",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ZALCON PHARMACY",
"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": "4 TRAILSIDE CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MANSFIELD",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76063-5463",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-939-4559",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9101 LAKEVIEW PKW",
"SecondLinePracticeLocationAddress": "STE. 500",
"PracticeLocationAddressCityName": "ROWLETT",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75088",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-412-7842",
"PracticeLocationAddressFaxNumber": "972-412-9884",
"EnumerationDate": "02/07/2011",
"LastUpdateDate": "02/14/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ONWUMERE",
"AuthorizedOfficialFirstName": "PRISCA",
"AuthorizedOfficialMiddleName": "N",
"AuthorizedOfficialTitle": "PHARMACIST-IN-CHARGE",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "817-939-4559",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "27332",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}