{
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"FirstLineMailingAddress": "2940 HOLLOW VALLEY DR",
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"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76244-5531",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "817-375-0538",
"FirstLinePracticeLocationAddress": "4000 FIVE POINTS DR STE 169",
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"PracticeLocationAddressTelephoneNumber": "817-375-0537",
"PracticeLocationAddressFaxNumber": "817-375-0538",
"EnumerationDate": "04/26/2016",
"LastUpdateDate": "05/20/2016",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GREGORY",
"AuthorizedOfficialFirstName": "TIMOTHY",
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"AuthorizedOfficialTelephoneNumber": "817-501-8327",
"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}