{
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"OrgName": "AMERICAN TELERADIOLOGY INC",
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"NamePrefix": null,
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"FirstLineMailingAddress": "PO BOX 701506",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75370-1506",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-210-7002",
"MailingAddressFaxNumber": "972-939-1293",
"FirstLinePracticeLocationAddress": "3208 COLE AVE",
"SecondLinePracticeLocationAddress": "SUITE 1208",
"PracticeLocationAddressCityName": "DALLAS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75204-1349",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-244-3156",
"PracticeLocationAddressFaxNumber": "214-880-0977",
"EnumerationDate": "05/27/2008",
"LastUpdateDate": "01/13/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VARGHESE",
"AuthorizedOfficialFirstName": "THOMAS",
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"AuthorizedOfficialTitle": "CEO",
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"AuthorizedOfficialCredential": "M.D",
"AuthorizedOfficialTelephoneNumber": "214-244-3156",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2085R0202X",
"TaxonomyName": "Diagnostic Radiology Physician",
"LicenseNumber": "L8990",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}