{
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"OrgName": "TERRY S WIGGINS MD PA",
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"FirstLineMailingAddress": "2765 BEE CAVES RD STE 201",
"SecondLineMailingAddress": "SUITE 201",
"MailingAddressCityName": "AUSTIN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78746-5640",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "512-328-2752",
"MailingAddressFaxNumber": "512-328-2751",
"FirstLinePracticeLocationAddress": "2712 BEECAVE RD",
"SecondLinePracticeLocationAddress": "SUITE 122",
"PracticeLocationAddressCityName": "AUSTIN",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressTelephoneNumber": "512-328-2752",
"PracticeLocationAddressFaxNumber": "512-328-2751",
"EnumerationDate": "04/29/2008",
"LastUpdateDate": "05/08/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHORTINO",
"AuthorizedOfficialFirstName": "ELIZABETH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "512-784-0997",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "E2940",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"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."
}
}
}
}