{
"Npi": {
"NPI": "1871882886",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PALOMA'S PHARMACY,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": "909 BUSINESS PARK DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MISSION",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78572-6052",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "956-424-6268",
"MailingAddressFaxNumber": "956-424-6258",
"FirstLinePracticeLocationAddress": "909 BUSINESS PARK DR STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MISSION",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78572-6054",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "956-424-6268",
"PracticeLocationAddressFaxNumber": "956-424-6258",
"EnumerationDate": "03/30/2011",
"LastUpdateDate": "05/12/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VELA",
"AuthorizedOfficialFirstName": "JOSE",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "CORP-PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM.D, R.PH.",
"AuthorizedOfficialTelephoneNumber": "956-821-2886",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "27433",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}