{
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"FirstLineMailingAddress": "11014 LINDEN GATE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77075-2440",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "832-308-1921",
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"FirstLinePracticeLocationAddress": "10065 ALMEDA GENOA RD STE J",
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"PracticeLocationAddressCityName": "HOUSTON",
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"PracticeLocationAddressFaxNumber": "832-308-1925",
"EnumerationDate": "01/15/2011",
"LastUpdateDate": "01/15/2011",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CABRERA",
"AuthorizedOfficialFirstName": "RODRIGO",
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"AuthorizedOfficialTitle": "PRESIDENT/DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "713-899-1789",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "23862",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}