{
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"FirstLineMailingAddress": "19702 BELLA LOMA APT 5301",
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"MailingAddressCityName": "SAN ANTONIO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78256-0005",
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"FirstLinePracticeLocationAddress": "23535 W INTERSTATE 10 STE 1102",
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"PracticeLocationAddressTelephoneNumber": "210-343-2541",
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"EnumerationDate": "05/30/2019",
"LastUpdateDate": "05/30/2019",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "CORDTS",
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"AuthorizedOfficialCredential": "PT, DPT",
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"Taxonomies": {
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"TaxonomyName": "Physical Therapy Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}