{
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"FirstLineMailingAddress": "8145 HIGHWAY 6 S STE 130A",
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"MailingAddressFaxNumber": "832-328-4162",
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"EnumerationDate": "02/16/2008",
"LastUpdateDate": "10/19/2025",
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"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EGEDE",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}