{
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"FirstLineMailingAddress": "1901 POST OAK BLVD",
"SecondLineMailingAddress": "4210",
"MailingAddressCityName": "HOUSTON",
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"MailingAddressPostalCode": "77056-3868",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-217-7492",
"MailingAddressFaxNumber": "281-888-2299",
"FirstLinePracticeLocationAddress": "6915 ANTOINE DRIVE",
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"PracticeLocationAddressTelephoneNumber": "832-288-4090",
"PracticeLocationAddressFaxNumber": "281-741-7406",
"EnumerationDate": "10/27/2010",
"LastUpdateDate": "09/30/2025",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TATARI",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "19937",
"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."
}
}
}
}