{
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"FirstLineMailingAddress": "PO BOX 004814",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT LOUIS",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63150-0001",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-466-1891",
"MailingAddressFaxNumber": "281-296-9044",
"FirstLinePracticeLocationAddress": "2180 NORTH LOOP W",
"SecondLinePracticeLocationAddress": "STE 320",
"PracticeLocationAddressCityName": "HOUSTON",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressTelephoneNumber": "832-384-1560",
"PracticeLocationAddressFaxNumber": "832-384-1585",
"EnumerationDate": "04/13/2009",
"LastUpdateDate": "04/13/2009",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KIM",
"AuthorizedOfficialFirstName": "HAESUE",
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"AuthorizedOfficialCredential": "M.D.",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
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"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}