{
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"FirstLineMailingAddress": "5122 MORNINGSIDE DR APT 815",
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"MailingAddressStateName": "TX",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1015 GIBBINS RD STE A",
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"PracticeLocationAddressCityName": "ARLINGTON",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressFaxNumber": "972-734-5433",
"EnumerationDate": "10/10/2022",
"LastUpdateDate": "11/01/2023",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOMBARDI",
"AuthorizedOfficialFirstName": "SUSAN",
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"AuthorizedOfficialCredential": "MD",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Internal Medicine Physician",
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"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."
}
}
}
}