{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "HOUSTON PROSTHODONTIC ASSOCIATES",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": "6",
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"FirstLineMailingAddress": "50 BRIAR HOLLOW LN",
"SecondLineMailingAddress": "SUITE 150 WEST",
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77027-9300",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "713-993-0003",
"MailingAddressFaxNumber": "713-993-0223",
"FirstLinePracticeLocationAddress": "50 BRIAR HOLLOW LN",
"SecondLinePracticeLocationAddress": "SUITE 150 WEST",
"PracticeLocationAddressCityName": "HOUSTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77027-9300",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "713-993-0003",
"PracticeLocationAddressFaxNumber": "713-993-0223",
"EnumerationDate": "10/05/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GITTLEMAN",
"AuthorizedOfficialFirstName": "NEAL",
"AuthorizedOfficialMiddleName": "BRUCE",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.M.D.",
"AuthorizedOfficialTelephoneNumber": "713-993-0003",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223P0700X",
"TaxonomyName": "Prosthodontics",
"LicenseNumber": "13876",
"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."
}
}
}
}