{
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"MailingAddressStateName": "TX",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-608-1868",
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"EnumerationDate": "10/19/2007",
"LastUpdateDate": "08/30/2024",
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"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}