{
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"EIN": null,
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"OrgName": "GENERAL SURGERY OF TEXAS PA",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "400 10TH ST E",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WACONIA",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55387-4552",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "888-209-0305",
"MailingAddressFaxNumber": "952-442-3620",
"FirstLinePracticeLocationAddress": "1860 HIGHWAY 71 S",
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"PracticeLocationAddressCityName": "COLUMBUS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78934-2816",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "832-865-5727",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/05/2011",
"LastUpdateDate": "12/21/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VASSER",
"AuthorizedOfficialFirstName": "HEATHER",
"AuthorizedOfficialMiddleName": "MARIE",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "832-865-5727",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "N3369",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}