{
"Npi": {
"NPI": "1962369090",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "UNITY TRANSITIONAL CARE OF TX PLLC",
"ParentOrgTIN": null,
"OrgName": "UNITY TRANSITIONAL CARE OF TX PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2330 ANNETTA CENTERPOINT RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALEDO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76008-2515",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-601-6079",
"MailingAddressFaxNumber": "866-398-0498",
"FirstLinePracticeLocationAddress": "226 PLAZA DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SIKESTON",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63801-5105",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "702-420-1671",
"PracticeLocationAddressFaxNumber": "949-331-1737",
"EnumerationDate": "01/09/2026",
"LastUpdateDate": "01/09/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FLO",
"AuthorizedOfficialFirstName": "FREDERICK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "915-282-1617",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}