{
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"FirstLineMailingAddress": "1011 MEDICAL PLAZA DR STE 130",
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"MailingAddressCityName": "THE WOODLANDS",
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"FirstLinePracticeLocationAddress": "1011 MEDICAL PLAZA DR STE 130",
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"EnumerationDate": "01/12/2026",
"LastUpdateDate": "01/13/2026",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RIVERA LOPEZ",
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"AuthorizedOfficialCredential": "DNP, APRN, FNP-BC,",
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}
},
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}
}