{
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"NamePrefix": null,
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"FirstLineMailingAddress": "1701 FAIRWAY DR STE 20",
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"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77511-4678",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-331-0020",
"MailingAddressFaxNumber": "281-585-0505",
"FirstLinePracticeLocationAddress": "1701 FAIRWAY DR STE 20",
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"PracticeLocationAddressCityName": "ALVIN",
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"PracticeLocationAddressPostalCode": "77511-4678",
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"PracticeLocationAddressFaxNumber": "281-585-0505",
"EnumerationDate": "01/13/2011",
"LastUpdateDate": "01/13/2011",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FOURNIER",
"AuthorizedOfficialFirstName": "RAYMOND",
"AuthorizedOfficialMiddleName": "B",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "281-331-0020",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1223G0001X",
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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{
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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."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
]
}
}
}