{
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"FirstLineMailingAddress": "PO BOX 781905",
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"MailingAddressStateName": "TX",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "210-527-1446",
"FirstLinePracticeLocationAddress": "925 SAN PEDRO AVE",
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"PracticeLocationAddressCityName": "SAN ANTONIO",
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"EnumerationDate": "07/17/2006",
"LastUpdateDate": "12/12/2013",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BHACHAWAT",
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"AuthorizedOfficialTitle": "OWNER PRESIDENT",
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"AuthorizedOfficialCredential": "MD",
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"Taxonomies": {
"Taxonomy": {
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"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."
}
}
}
}