{
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"FirstLineMailingAddress": "706 HUNTERS ROW CT",
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"MailingAddressCityName": "MANSFIELD",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76063-4001",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "682-518-8111",
"MailingAddressFaxNumber": "682-518-8112",
"FirstLinePracticeLocationAddress": "706 HUNTERS ROW CT",
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"PracticeLocationAddressFaxNumber": "682-518-8112",
"EnumerationDate": "03/17/2011",
"LastUpdateDate": "03/17/2011",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TOMBERLIN",
"AuthorizedOfficialFirstName": "JULIE",
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"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "682-518-8111",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pediatric Adolescent Medicine Physician",
"LicenseNumber": "L3703",
"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."
}
}
}
}