{
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"FirstLineMailingAddress": "2203 BEAR LAKE DR",
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"MailingAddressStateName": "TX",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "900 N INDUSTRIAL BLVD STE 400",
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"PracticeLocationAddressTelephoneNumber": "682-214-8806",
"PracticeLocationAddressFaxNumber": "682-334-7492",
"EnumerationDate": "10/01/2024",
"LastUpdateDate": "01/15/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RODRIGUEZ",
"AuthorizedOfficialFirstName": "RICARDO",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Optometrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}