{
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"EIN": null,
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"ParentOrgLBN": null,
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"NamePrefix": null,
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"Credential": null,
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"FirstLineMailingAddress": "7055 ADDICKS CLODINE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77083-2303",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-568-5251",
"MailingAddressFaxNumber": "281-933-1935",
"FirstLinePracticeLocationAddress": "7055 ADDICKS CLODINE RD",
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"PracticeLocationAddressCityName": "HOUSTON",
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"PracticeLocationAddressTelephoneNumber": "281-568-5251",
"PracticeLocationAddressFaxNumber": "281-933-1935",
"EnumerationDate": "04/10/2014",
"LastUpdateDate": "10/31/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALLEN",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "832-418-9322",
"Taxonomies": {
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"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}