{
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"FirstLineMailingAddress": "1750 E LEAGUE CITY PKWY APT 234",
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"MailingAddressStateName": "TX",
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"FirstLinePracticeLocationAddress": "7995 BELLFORT ST",
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"EnumerationDate": "11/29/2023",
"LastUpdateDate": "11/29/2023",
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"GenderCode": null,
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"AuthorizedOfficialLastName": "TRUONG",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}