{
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"FirstLineMailingAddress": "8230 WALNUT HILL LN STE 700",
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"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75231-4436",
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"FirstLinePracticeLocationAddress": "221 W. COLORADO BLVD",
"SecondLinePracticeLocationAddress": "METHODIST PAVILION II, SUITE 441",
"PracticeLocationAddressCityName": "DALLAS",
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"EnumerationDate": "04/04/2016",
"LastUpdateDate": "08/31/2021",
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Urology Physician",
"LicenseNumber": "T2559",
"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."
}
}
}
}