INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('760454609', 'ELAFA0184', 'ELAFA0184', 'TXHOUSTD', 'Renal Specialists of Houston', 'Humaira', '', 'Chaudhary', 'MD', 'Nephrology', '', '', NULL, 'O', '4201 Garth Rd Ste 319', 'Baytown', 'Harris', 'TX', '77521', '2814282487', '2814282784', '4201 Garth Rd Ste 319', 'Baytown', 'Harris', 'TX', '77521', '2814282487', '2814282784', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-01', 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist San Jacinto Hospital', NULL, NULL, 'HCFA|UB|', '1912904996', 0, 'N', 0, '2013-03-21', NULL, NULL, 29.7677, -94.9796, NULL, NULL),
('760454609', 'ELAFA0187', 'ELAFA0187', 'TXHOUSTD', 'Renal Specialists of Houston', 'Humaira', '', 'Chaudhary', 'MD', 'Nephrology', '', '', NULL, 'O', '4407 Yoakum', 'Houston', 'Harris', 'TX', '77006', '7135288111', '7135282276', '4407 Yoakum', 'Houston', 'Harris', 'TX', '77006', '7135288111', '7135282276', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-01', 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist San Jacinto Hospital', NULL, NULL, 'HCFA|UB|', '1912904996', 0, 'N', 0, '2013-03-21', NULL, NULL, 29.7333, -95.3921, NULL, NULL),
('760454609', 'ELAFA0188', 'ELAFA0188', 'TXHOUSTD', 'Renal Specialists of Houston', 'Humaira', '', 'Chaudhary', 'MD', 'Nephrology', '', '', NULL, 'O', '5435 Aldine Mail Rd', 'Houston', 'Harris', 'TX', '77039', '8323812441', '8323812443', '5435 Aldine Mail Rd', 'Houston', 'Harris', 'TX', '77039', '8323812441', '8323812443', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist San Jacinto Hospital', NULL, NULL, 'HCFA|UB|', '1912904996', 0, 'N', 0, '2013-03-21', NULL, NULL, 29.9022, -95.3095, NULL, NULL),
('760454609', 'ELAFA0182', 'ELAFA0182', 'TXHOUSTD', 'Renal Specialists of Houston', 'Humaira', '', 'Chaudhary', 'MD', 'Nephrology', '', '', NULL, 'O', '6624 Fannin St Ste 2510', 'Houston', 'Harris', 'TX', '77030', '7137912648', '7137950717', '6624 Fannin St Ste 2510', 'Houston', 'Harris', 'TX', '77030', '7137912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-01', 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist San Jacinto Hospital', NULL, NULL, 'HCFA|UB|', '1912904996', 0, 'N', 0, '2013-03-21', NULL, NULL, 29.7092, -95.402, NULL, NULL),
('760454609', 'ELAFA0189', 'ELAFA0189', 'TXHOUSTD', 'Renal Specialists of Houston', 'Humaira', '', 'Chaudhary', 'MD', 'Nephrology', '', '', NULL, 'O', '8537 Gulf Fwy Ste C', 'Houston', 'Harris', 'TX', '77017', '8323860900', '8323860907', '8537 Gulf Fwy Ste C', 'Houston', 'Harris', 'TX', '77017', '8323860900', '8323860907', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist San Jacinto Hospital', NULL, NULL, 'HCFA|UB|', '1912904996', 0, 'N', 0, '2013-03-21', NULL, NULL, 29.6682, -95.2613, NULL, NULL),
('760454609', 'ELAFA0193', 'ELAFA0193', 'TXHOUSTD', 'Renal Specialists of Houston', 'Humaira', '', 'Chaudhary', 'MD', 'Nephrology', '', '', NULL, 'O', '9449 Grogans Mill', 'The Woodlands', 'Montgomery', 'TX', '77380', '7137912648', '7137950717', '9449 Grogans Mill', 'The Woodlands', 'Montgomery', 'TX', '77380', '7137912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-01', 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist San Jacinto Hospital', NULL, NULL, 'HCFA|UB|', '1912904996', 0, 'N', 0, '2013-03-21', NULL, NULL, 30.1664, -95.4661, NULL, NULL),
('760454609', 'ELAFA0119', 'ELAFA0119', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '10970 Shadow Creek Pkwy', 'Pearland', 'Brazoria', 'TX', '77584', '7137912648', '7137950717', '10970 Shadow Creek Pkwy', 'Pearland', 'Brazoria', 'TX', '77584', '7137912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.5802, -95.3886, NULL, NULL),
('760454609', 'ELAFA0114', 'ELAFA0114', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '11914 Astoria Blvd Ste 530', 'Houston', 'Harris', 'TX', '77089', '2814649681', '2814647593', '11914 Astoria Blvd Ste 530', 'Houston', 'Harris', 'TX', '77089', '2814649681', '2814647593', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.5851, -95.2071, NULL, NULL),
('760454609', 'ELAFA0120', 'ELAFA0120', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '16126 Southwest Fwy Ste 230', 'Sugar Land', 'Fort Bend', 'TX', '77479', '7139444660', '8323812444', '16126 Southwest Fwy Ste 230', 'Sugar Land', 'Fort Bend', 'TX', '77479', '7139444660', '8323812444', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.5968, -95.6249, NULL, NULL),
('760454609', 'ELAFA0110', 'ELAFA0110', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '250 Blossom Ste 275', 'Webster', 'Harris', 'TX', '77598', '2813322059', '2813160731', '250 Blossom Ste 275', 'Webster', 'Harris', 'TX', '77598', '2813322059', '2813160731', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.5436, -95.126, NULL, NULL),
('760454609', 'ELAFA0112', 'ELAFA0112', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '2825 S Loop 35 Ste 154', 'Alvin', 'Brazoria', 'TX', '77511', '7137912648', '7137950717', '2825 S Loop 35 Ste 154', 'Alvin', 'Brazoria', 'TX', '77511', '7137912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-07-02', 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.4028, -95.2374, NULL, NULL),
('760454609', 'ELAFA0118', 'ELAFA0118', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '3333 Bayshore Blvd Ste 270', 'Pasadena', 'Harris', 'TX', '77504', '7139479507', '7139476286', '3333 Bayshore Blvd Ste 270', 'Pasadena', 'Harris', 'TX', '77504', '7139479507', '7139476286', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.663, -95.1837, NULL, NULL),
('760454609', 'ELAFA0113', 'ELAFA0113', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '4201 Garth Rd Ste 319', 'Baytown', 'Harris', 'TX', '77521', '2814282487', '2814282784', '4201 Garth Rd Ste 319', 'Baytown', 'Harris', 'TX', '77521', '2814282487', '2814282784', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-07-29', 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.7677, -94.9796, NULL, NULL),
('760454609', 'ELAFA0115', 'ELAFA0115', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '4407 Yoakum', 'Houston', 'Harris', 'TX', '77006', '7135288111', '7135282276', '4407 Yoakum', 'Houston', 'Harris', 'TX', '77006', '7135288111', '7135282276', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.7335, -95.3924, NULL, NULL),
('760454609', 'ELAFA0116', 'ELAFA0116', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '5435 Aldine Mail Rd', 'Houston', 'Harris', 'TX', '77039', '8323812441', '8323812443', '5435 Aldine Mail Rd', 'Houston', 'Harris', 'TX', '77039', '8323812441', '8323812443', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.9022, -95.3095, NULL, NULL),
('760454609', 'ELAFA0111', 'ELAFA0111', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '6624 Fannin St Ste 2510', 'Houston', 'Harris', 'TX', '77030', '7137912648', '7137950717', '6624 Fannin St Ste 2510', 'Houston', 'Harris', 'TX', '77030', '7137912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.7096, -95.4011, NULL, NULL),
('760454609', 'ELAFA0117', 'ELAFA0117', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '8537 Gulf Fwy Ste C', 'Houston', 'Harris', 'TX', '77017', '8323860900', '8323860907', '8537 Gulf Fwy Ste C', 'Houston', 'Harris', 'TX', '77017', '8323860900', '8323860907', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 29.6682, -95.2613, NULL, NULL),
('760454609', 'ELAFA0121', 'ELAFA0121', 'TXHOUSTD', 'Renal Specialists of Houston', 'Camilo', 'G', 'Barcenas', 'MD', 'Nephrology', '', '', NULL, 'O', '9449 Grogans Mill', 'The Woodlands', 'Montgomery', 'TX', '77380', '7137912648', '7137950717', '9449 Grogans Mill', 'The Woodlands', 'Montgomery', 'TX', '77380', '7137912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', 'Houston Methodist Hospital', 'Houston Methodist San Jacinto Hospital', NULL, 'HCFA|UB|', '1932125929', 0, 'N', 0, '2013-07-31', NULL, NULL, 30.1672, -95.4656, NULL, NULL),
('760454609', 'ELAFA0095', 'ELAFA0095', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '10970 Shadow Creek Pkwy', 'Pearland', 'Brazoria', 'TX', '77584', '7137912648', '7137950717', '10970 Shadow Creek Pkwy', 'Pearland', 'Brazoria', 'TX', '77584', '7137912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'Y', 0, '2013-05-10', NULL, NULL, 29.5802, -95.3886, NULL, NULL),
('760454609', 'ELAFA0089', 'ELAFA0089', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '11914 Astoria Blvd Ste 530', 'Houston', 'Harris', 'TX', '77089', '2814649681', '2814647593', '11914 Astoria Blvd Ste 530', 'Houston', 'Harris', 'TX', '77089', '2814649681', '2814647593', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'Y', 0, '2013-05-10', NULL, NULL, 29.5851, -95.2071, NULL, NULL),
('760454609', 'ELAFA0096', 'ELAFA0096', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '16126 Southwest Fwy Ste 230', 'Sugar Land', 'Fort Bend', 'TX', '77479', '7139444660', '8323812444', '16126 Southwest Fwy Ste 230', 'Sugar Land', 'Fort Bend', 'TX', '77479', '7139444660', '8323812444', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'Y', 0, '2013-05-10', NULL, NULL, 29.5968, -95.6249, NULL, NULL),
('760454609', 'ELAFA0090', 'ELAFA0090', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '250 Blossom Ste 275', 'Webster', 'Harris', 'TX', '77598', '2813322059', '2813160731', '250 Blossom Ste 275', 'Webster', 'Harris', 'TX', '77598', '2813322059', '2813160731', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'Y', 0, '2013-05-10', NULL, NULL, 29.5436, -95.126, NULL, NULL),
('760454609', 'ELAFA0087', 'ELAFA0087', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '2825 S Loop 35 Ste 154', 'Alvin', 'Brazoria', 'TX', '77511', '7137912648', '7137950717', '2825 S Loop 35 Ste 154', 'Alvin', 'Brazoria', 'TX', '77511', '7137912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'Y', 0, '2013-05-10', NULL, NULL, 29.3988, -95.2459, NULL, NULL),
('760454609', 'ELAFA0094', 'ELAFA0094', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '3333 Bayshore Blvd Ste 270', 'Pasadena', 'Harris', 'TX', '77504', '7139479507', '7139476286', '3333 Bayshore Blvd Ste 270', 'Pasadena', 'Harris', 'TX', '77504', '7139479507', '7139476286', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'Y', 0, '2013-05-10', NULL, NULL, 29.663, -95.1837, NULL, NULL),
('760454609', 'ELAFA0088', 'ELAFA0088', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '4201 Garth Rd Ste 319', 'Baytown', 'Harris', 'TX', '77521', '2814282487', '2814282784', '4201 Garth Rd Ste 319', 'Baytown', 'Harris', 'TX', '77521', '2814282487', '2814282784', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'Y', 0, '2013-05-10', NULL, NULL, 29.7677, -94.9775, NULL, NULL),
('760454609', 'ELAFA0091', 'ELAFA0091', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '4407 Yoakum', 'Houston', 'Harris', 'TX', '77006', '7135288111', '7135282276', '4407 Yoakum', 'Houston', 'Harris', 'TX', '77006', '7135288111', '7135282276', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'N', 0, '2013-05-10', NULL, NULL, 29.7335, -95.3924, NULL, NULL),
('760454609', 'ELAFA0092', 'ELAFA0092', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '5435 Aldine Mail Rd', 'Houston', 'Harris', 'TX', '77039', '8323812441', '8323812443', '5435 Aldine Mail Rd', 'Houston', 'Harris', 'TX', '77039', '8323812441', '8323812443', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'N', 0, '2013-05-10', NULL, NULL, 29.9022, -95.3095, NULL, NULL),
('760454609', 'ELAFA0086', 'ELAFA0086', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '6624 Fannin St Ste 2510', 'Houston', 'Harris', 'TX', '77030', '7134912648', '7137950717', '6624 Fannin St Ste 2510', 'Houston', 'Harris', 'TX', '77030', '7134912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'N', 0, '2013-05-10', NULL, NULL, 29.7096, -95.4011, NULL, NULL),
('760454609', 'ELAFA0093', 'ELAFA0093', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '8537 Gulf Fwy Ste C', 'Houston', 'Harris', 'TX', '77017', '8323860900', '8323860907', '8537 Gulf Fwy Ste C', 'Houston', 'Harris', 'TX', '77017', '8323860900', '8323860907', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'N', 0, '2013-05-10', NULL, NULL, 29.6682, -95.2613, NULL, NULL),
('760454609', 'ELAFA0097', 'ELAFA0097', 'TXHOUSTD', 'Renal Specialists of Houston', 'Debbie', 'G', 'Kurian', 'MD', 'Nephrology', '', '', NULL, 'O', '9449 Grogans Mill', 'The Woodlands', 'Montgomery', 'TX', '77380', '7137912648', '7137950717', '9449 Grogans Mill', 'The Woodlands', 'Montgomery', 'TX', '77380', '7137912648', '7137950717', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist San Jacinto Hospital', NULL, '', '', 'HCFA|UB|', '1962766386', 0, 'N', 0, '2013-05-10', NULL, NULL, 30.1672, -95.4656, NULL, NULL),
('363954552', 'ELRHC0201', 'ELRHC0201', 'ILCHIGSTD', 'Sage Medical Group', 'Bruce', 'D', 'Goldenberg', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60630', '7735497757', '7737940138', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60630', '7735497757', '7737940138', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Our Lady Of The Resurrection Medical Center', 'Presence Saint Joseph Hospital Chicago', '', '', 'HCFA|UB|', '1528172236', 0, 'N', 0, '2014-02-06', NULL, NULL, 41.9253, -87.6576, NULL, NULL),
('363954552', 'ELRHC0101', 'ELRHC0101', 'ILCHIGSTD', 'Sage Medical Group', 'Marilyn', 'S', 'Aden', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60614', '7735497757', '7735491221', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60614', '7735497757', '7735491221', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', '', 'HCFA|UB|', '1598768152', 0, 'N', 0, '2014-02-06', NULL, NULL, 41.9253, -87.6576, NULL, NULL),
('363954552', 'ELRHC0116', 'ELRHC0116', 'ILCHIGSTD', 'Sage Medical Group', 'Michael', 'D', 'Baldinger', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60614', '7735497757', '7735491221', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60614', '7735497757', '7735491221', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', '', 'HCFA|UB|', '1598879223', 0, 'N', 0, '2014-02-06', NULL, NULL, 41.9253, -87.6576, NULL, NULL),
('363954552', 'ELRHC0257', 'ELRHC0257', 'ILCHIGSTD', 'Sage Medical Group', 'Elisabeth', '', 'Klor-Gross', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60614', '7735497757', '7735491221', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60614', '7735497757', '7735491221', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', '', 'HCFA|UB|', '1609879279', 0, 'N', 0, '2014-02-06', NULL, NULL, 41.9253, -87.6576, NULL, NULL),
('363954552', 'ELRHC0324', 'ELRHC0324', 'ILCHIGSTD', 'Sage Medical Group', 'Paul', 'B', 'Odland', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60614', '7735497757', '7735491221', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60614', '7735497757', '7735491221', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, '', '', 'HCFA|UB|', '1760596464', 0, 'N', 0, '2014-02-06', NULL, NULL, 41.9253, -87.6576, NULL, NULL),
('363954552', 'ELRHC0365', 'ELRHC0365', 'ILCHIGSTD', 'Sage Medical Group', 'Guy', '', 'Rowley', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60630', '7735497757', '7737940138', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60630', '7735497757', '7737940138', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Our Lady Of The Resurrection Medical Center', 'Presence Saint Joseph Hospital Chicago', '', '', 'HCFA|UB|', '1972617074', 0, 'N', 0, '2014-02-06', NULL, NULL, 41.9253, -87.6576, NULL, NULL),
('030374787', 'W12027485', 'W12027485', 'TXDALSTD', 'Health Texas Provider Network', '', '', 'Health Texas Provider Network', '', 'Clinics', '', '', NULL, 'O', '3600 Gaston Ave Ste 958 W', 'Dallas', 'Dallas', 'TX', '75246', '2148266276', '2148266223', '3600 Gaston Ave Ste 958 W', 'Dallas', 'Dallas', 'TX', '75246', '2148266276', '2148266223', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010024', 0, 'Y', 0, '2013-12-30', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('751037591', 'W12027486', 'W12027486', 'TXDALSTD', 'Health Texas Provider Network', '', '', 'Health Texas Provider Network', '', 'Clinics', '', '', NULL, 'B', 'PO Box 841540', 'Dallas', 'Dallas', 'TX', '75284', '9724953578', '9724969239', 'PO Box 841540', 'Dallas', 'Dallas', 'TX', '75284', '9724953578', '9724969239', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010024', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('751837454', 'W12027487', 'W12027487', 'TXDALSTD', 'Health Texas Provider Network', '', '', 'Health Texas Provider Network', '', 'Clinics', '', '', NULL, 'B', 'PO Box 844013', 'Dallas', 'Dallas', 'TX', '75284', '2148209480', '2148208995', 'PO Box 844013', 'Dallas', 'Dallas', 'TX', '75284', '2148209480', '2148208995', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010024', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'W12027491', 'W12027491', 'TXDALSTD', 'Health Texas Provider Network', '', '', 'Health Texas Provider Network', '', 'Clinics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010024', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'W12027488', 'W12027488', 'TXDALSTD', 'Health Texas Provider Network', '', '', 'Health Texas Provider Network', '', 'Clinics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010024', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'W12027482', 'W12027482', 'TXDALSTD', 'Health Texas Provider Network', '', '', 'Health Texas Provider Network', '', 'Clinics', '', '', NULL, 'B', '3434 Swiss Ave Ste 201', 'Dallas', 'Dallas', 'TX', '75204', '2148285006', '2148285080', '3434 Swiss Ave Ste 201', 'Dallas', 'Dallas', 'TX', '75204', '2148285006', '2148285080', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010024', 0, 'Y', 0, '2013-12-30', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752722718', 'W12027489', 'W12027489', 'TXDALSTD', 'Health Texas Provider Network', '', '', 'Health Texas Provider Network', '', 'Clinics', '', '', NULL, 'B', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010024', 0, 'Y', 0, '2013-12-30', NULL, NULL, 32.797, -97.0554, NULL, NULL),
('911947573', 'W12027483', 'W12027483', 'TXDALSTD', 'Health Texas Provider Network', '', '', 'Health Texas Provider Network', '', 'Clinics', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010024', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('911982510', 'W12027490', 'W12027490', 'TXDALSTD', 'Health Texas Provider Network', '', '', 'Health Texas Provider Network', '', 'Clinics', '', '', NULL, 'B', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010024', 0, 'Y', 0, '2013-12-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00341', 'ELHT00341', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Vijaya', 'L', 'Mummadi', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003026410', 0, 'Y', 0, '2014-01-17', NULL, NULL, 32.9192, -96.6635, NULL, NULL),
('752536818', 'ELHT00342', 'ELHT00342', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Vijaya', 'L', 'Mummadi', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003026410', 0, 'N', 0, '2014-01-17', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00343', 'ELHT00343', 'TXDALSTD', 'McKinney Inpatient Care Unit', 'Irene', 'A', 'Carrothers', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5252 W University Dr', 'McKinney', 'Collin', 'TX', '75071', '4697646950', '4697646954', '5252 W University Dr', 'McKinney', 'Collin', 'TX', '75071', '4697646950', '4697646954', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003041831', 0, 'Y', 0, '2013-05-01', NULL, NULL, 33.2183, -96.6841, NULL, NULL),
('752536818', 'ELHT00344', 'ELHT00344', 'TXDALSTD', 'McKinney Inpatient Care Unit', 'Irene', 'A', 'Carrothers', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003041831', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01113', 'ELHT01113', 'TXDALSTD', 'Cottonwood Cardiology', 'Padmavathy', '', 'Uppalapati', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1110 Cottonwood Ln Ste 105', 'Irving', 'Dallas', 'TX', '75038', '9726072525', '9722528837', '1110 Cottonwood Ln Ste 105', 'Irving', 'Dallas', 'TX', '75038', '9726072525', '9722528837', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1003816745', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8652, -96.9601, NULL, NULL),
('752536818', 'ELHT01114', 'ELHT01114', 'TXDALSTD', 'Cottonwood Cardiology', 'Padmavathy', '', 'Uppalapati', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1003816745', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00793', 'ELHT00793', 'TXDALSTD', 'Family Medical Center at North Garland', 'Eric', 'D', 'Beshires', 'MD', 'Family Practice', '', '', NULL, 'O', '5345 N George Bush Fwy', 'Garland', 'Dallas', 'TX', '75040', '9724955888', '9724950588', '5345 N George Bush Fwy', 'Garland', 'Dallas', 'TX', '75040', '9724955888', '9724950588', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003846445', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9651, -96.6418, NULL, NULL),
('752536818', 'ELHT00794', 'ELHT00794', 'TXDALSTD', 'Family Medical Center at North Garland', 'Eric', 'D', 'Beshires', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003846445', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00345', 'ELHT00345', 'TXDALSTD', 'Internal Medicine Associates at Southwest Ft Worth', 'Paul', 'J', 'Garcia', 'DO', 'Internal Medicine', '', '', NULL, 'O', '5701 Bryant Irvin Rd Ste 302', 'Ft Worth', 'Tarrant', 'TX', '76132', '8172949000', '8172949010', '5701 Bryant Irvin Rd Ste 302', 'Ft Worth', 'Tarrant', 'TX', '76132', '8172949000', '8172949010', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', NULL, 'HCFA|UB|', '1003870981', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.6664, -97.4199, NULL, NULL),
('752536818', 'ELHT00346', 'ELHT00346', 'TXDALSTD', 'Internal Medicine Associates at Southwest Ft Worth', 'Paul', 'J', 'Garcia', 'DO', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', NULL, 'HCFA|UB|', '1003870981', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911982510', 'ELHT00795', 'ELHT00795', 'TXDALSTD', 'Family Medical Center at Terrell', 'Christian', 'A', 'Lance', 'MD', 'Family Practice', '', '', NULL, 'O', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003903584', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7372, -96.2749, NULL, NULL),
('911982510', 'ELHT00796', 'ELHT00796', 'TXDALSTD', 'Family Medical Center at Terrell', 'Christian', 'A', 'Lance', 'MD', 'Family Practice', '', '', NULL, 'B', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003903584', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00311', 'ELHT00311', 'TXDALSTD', 'Neurology Hospitalist Group', 'Sadat', 'A', 'Shamim', 'MD', 'Neurology', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 1155', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', '3600 Gaston Ave Wadley Ste 1155 ', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1013064435', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00312', 'ELHT00312', 'TXDALSTD', 'Neurology Hospitalist Group', 'Sadat', 'A', 'Shamim', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1013064435', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911982510', 'ELHT00797', 'ELHT00797', 'TXDALSTD', 'Family Medical Center at Terrell', 'Nicole', 'S', 'Swofford', 'MD', 'Family Practice', '', '', NULL, 'O', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013177948', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7372, -96.2749, NULL, NULL),
('911982510', 'ELHT00798', 'ELHT00798', 'TXDALSTD', 'Family Medical Center at Terrell', 'Nicole', 'S', 'Swofford', 'MD', 'Family Practice', '', '', NULL, 'B', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013177948', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01185', 'ELHT01185', 'TXDALSTD', 'Cardiovascular Consultants of North Texas', 'Raul', 'A', 'Santos', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1600 W College Ste 680', 'Grapevine', 'Tarrant', 'TX', '76051', '8179128400', '8179128410', '1600 W College Ste 680', 'Grapevine', 'Tarrant', 'TX', '76051', '8179128400', '8179128410', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor Regional Medical Center at Plano', NULL, NULL, 'HCFA|UB|', '1013926039', 0, 'N', 0, '2013-12-09', NULL, NULL, 32.9345, -97.0946, NULL, NULL),
('752536818', 'ELHT01186', 'ELHT01186', 'TXDALSTD', 'Cardiovascular Consultants of North Texas', 'Raul', 'A', 'Santos', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor Regional Medical Center at Plano', NULL, NULL, 'HCFA|UB|', '1013926039', 0, 'Y', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00715', 'ELHT00715', 'TXDALSTD', 'Texas Surgical Specialists', 'Watson', 'P', 'Roye', 'MD', 'General Surgery', '', '', NULL, 'O', '1305 W Jefferson Ste 120', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231457', '9729231304', '1305 W Jefferson Ste 120', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231457', '9729231304', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1013932466', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.3961, -96.8638, NULL, NULL),
('911947573', 'ELHT00716', 'ELHT00716', 'TXDALSTD', 'Texas Surgical Specialists', 'Watson', 'P', 'Roye', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1013932466', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00165', 'ELHT00165', 'TXDALSTD', 'Health Texas Provider Network', 'Matt', 'Y', 'Bayazitoglu', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '411N Washington Ave Ste 4000', 'Dallas', 'Dallas', 'TX', '75246', '2148208557', '9724808356', '411N Washington Ave Ste 4000', 'Dallas', 'Dallas', 'TX', '75246', '2148208557', '9724808356', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor University Medical Center', NULL, NULL, 'HCFA|UB|', '1013936715', 0, 'N', 0, '2013-06-12', NULL, NULL, 32.7885, -96.7752, NULL, NULL),
('752536818', 'ELHT00166', 'ELHT00166', 'TXDALSTD', 'Health Texas Provider Network', 'Matt', 'Y', 'Bayazitoglu', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor University Medical Center', NULL, NULL, 'HCFA|UB|', '1013936715', 0, 'N', 0, '2013-06-12', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00253', 'ELHT00253', 'TXDALSTD', 'The Shoulder Center', 'Sumant', 'G', 'Krishnan', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3900 Junius Ste 740', 'Dallas', 'Dallas', 'TX', '75246', '2148182700', '2148182710', '3900 Junius Ste 740', 'Dallas', 'Dallas', 'TX', '75246', '2148182700', '2148182710', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1013939487', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.791, -96.7782, NULL, NULL),
('911947573', 'ELHT00254', 'ELHT00254', 'TXDALSTD', 'The Shoulder Center', 'Sumant', 'G', 'Krishnan', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148182700', '2148182710', 'PO Box 842001  ', 'Dallas', 'Dallas', 'TX', '75284', '2148182700', '2148182710', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1013939487', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00119', 'ELHT00119', 'TXDALSTD', 'North Hills Vascular', 'Travis', 'A', 'Foster', 'MD', 'Vascular Surgery', '', '', NULL, 'O', '4375 Booth Calloway Ste 501', 'North Richland Hills', 'Tarrant', 'TX', '76180', '8172844500', '8172844505', '4375 Booth Calloway Ste 501', 'North Richland Hills', 'Tarrant', 'TX', '76180', '8172844500', '8172844505', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-14', 0, 0, 0, 'Baylor Regional Medical Center at Grapevine', NULL, NULL, NULL, 'HCFA|UB|', '1013962349', 0, 'N', 0, '2013-11-11', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00120', 'ELHT00120', 'TXDALSTD', 'North Hills Vascular', 'Travis', 'A', 'Foster', 'MD', 'Vascular Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-14', 0, 0, 0, 'Baylor Regional Medical Center at Grapevine', NULL, NULL, NULL, 'HCFA|UB|', '1013962349', 0, 'N', 0, '2013-11-11', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01115', 'ELHT01115', 'TXDALSTD', 'Cardiology Consultants of Texas', 'John', 'W', 'Hyland', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '621 N Hall St Ste 400', 'Dallas', 'Dallas', 'TX', '75226', '2148248721', '2142376529', '621 N Hall St Ste 400', 'Dallas', 'Dallas', 'TX', '75226', '2148248721', '2142376529', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1013981240', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7879, -96.7802, NULL, NULL),
('752536818', 'ELHT01116', 'ELHT01116', 'TXDALSTD', 'Cardiology Consultants of Texas', 'John', 'W', 'Hyland', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1013981240', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00699', 'ELHT00699', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Jill', 'L', 'Studley', 'MD', 'Geriatrics', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', 'Baylor Regional Medical Center at Plano', '', '', 'HCFA|UB|', '1023049053', 0, 'Y', 0, '2014-04-17', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00700', 'ELHT00700', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Jill', 'L', 'Studley', 'MD', 'Geriatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', 'Baylor Regional Medical Center at Plano', '', '', 'HCFA|UB|', '1023049053', 0, 'Y', 0, '2014-04-17', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00347', 'ELHT00347', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Red Oak', 'Jason', 'R', 'Nordstrom', 'MD', 'Internal Medicine', '', '', NULL, 'O', '301 E Ovilla Rd Ste 100', 'Red Oak', 'Ellis', 'TX', '75154', '9726175225', '9726177922', '301 E Ovilla Rd Ste 100', 'Red Oak', 'Ellis', 'TX', '75154', '9726175225', '9726177922', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1023058815', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.5318, -96.8051, NULL, NULL),
('911947573', 'ELHT00348', 'ELHT00348', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Red Oak', 'Jason', 'R', 'Nordstrom', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1023058815', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00349', 'ELHT00349', 'TXDALSTD', '', 'Fathima', 'A', 'Arab', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1023070794', 0, 'Y', 0, '2014-01-30', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00350', 'ELHT00350', 'TXDALSTD', '', 'Fathima', 'A', 'Arab', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1023070794', 0, 'Y', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00799', 'ELHT00799', 'TXDALSTD', 'Baylor Family Health Center at Richardson', 'Linda', 'S', 'Halbrook', 'MD', 'Family Practice', '', '', NULL, 'O', '2520 N Central Expwy Ste 100', 'Richardson', 'Dallas', 'TX', '75080', '9722343311', '9726698072', '2520 North Central Expy Ste 100', 'Richardson', 'Dallas', 'TX', '75080', '9722343311', '9726698072', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1023073491', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.986, -96.7108, NULL, NULL),
('752536818', 'ELHT00800', 'ELHT00800', 'TXDALSTD', 'Baylor Family Health Center at Richardson', 'Linda', 'S', 'Halbrook', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1023073491', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00351', 'ELHT00351', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Deepika', 'A', 'Reddy', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033306238', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.8341, -96.9592, NULL, NULL),
('752536818', 'ELHT00352', 'ELHT00352', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Deepika', 'A', 'Reddy', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033306238', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01187', 'ELHT01187', 'TXDALSTD', 'Cottonwood Cardiology', 'Nauman', '', 'Siddiqi', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1110 Cottonwood Ln Ste 105', 'Irving', 'Dallas', 'TX', '75038', '9726072525', '9722528837', '1110 Cottonwood Ln Ste 105', 'Irving', 'Dallas', 'TX', '75038', '9726072525', '9722528837', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1033381546', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8652, -96.9601, NULL, NULL),
('752536818', 'ELHT01188', 'ELHT01188', 'TXDALSTD', 'Cottonwood Cardiology', 'Nauman', '', 'Siddiqi', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1033381546', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('752600832', 'ELHT00355', 'ELHT00355', 'TXDALSTD', '', 'W Mark', '', 'Armstrong', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 420', 'Dallas', 'Dallas', 'TX', '75204', '2148285020', '2148285021', '3434 Swiss Ave Ste 420', 'Dallas', 'Dallas', 'TX', '75204', '2148285020', '2148285021', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1043220957', 0, 'N', 0, '2014-01-30', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT00199', 'ELHT00199', 'TXDALSTD', 'North Texas Health Care Associates Pediatrics', 'Michelle', 'B', 'Fowers', 'MD', 'Pediatrics', '', '', NULL, 'O', '400 W IH 635 Ste 250', 'Irving', 'Dallas', 'TX', '75063', '9724816400', '9728319794', '400 W IH 635 Ste 250', 'Irving', 'Dallas', 'TX', '75063', '9724816400', '9728319794', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, '', NULL, 'HCFA|UB|', '1043243744', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9125, -96.9492, NULL, NULL),
('752536818', 'ELHT00200', 'ELHT00200', 'TXDALSTD', 'North Texas Health Care Associates Pediatrics', 'Michelle', 'B', 'Fowers', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, '', NULL, 'HCFA|UB|', '1043243744', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00801', 'ELHT00801', 'TXDALSTD', 'Baylor Family Medicine at Fort Worth', 'Craig', 'C', 'Kneten', 'MD', 'Family Practice', '', '', NULL, 'O', '900 W Magnolia Ave Ste 201', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179216166', '8179219594', '900 W Magnolia Ste 201', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179216166', '8179219594', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1043278815', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7306, -97.3342, NULL, NULL),
('752536818', 'ELHT00802', 'ELHT00802', 'TXDALSTD', 'Baylor Family Medicine at Fort Worth', 'Craig', 'C', 'Kneten', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1043278815', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00357', 'ELHT00357', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Gayathri', 'S', 'Vontivillu', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043291321', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.8341, -96.9592, NULL, NULL),
('752536818', 'ELHT00358', 'ELHT00358', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Gayathri', 'S', 'Vontivillu', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043291321', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00359', 'ELHT00359', 'TXDALSTD', '', 'Harman', 'P', 'Kaur', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1043434152', 0, 'N', 0, '2014-01-24', NULL, NULL, 32.3968, -96.865, NULL, NULL),
('911947573', 'ELHT00360', 'ELHT00360', 'TXDALSTD', '', 'Harman', 'P', 'Kaur', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1043434152', 0, 'N', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00033', 'ELHT00033', 'TXDALSTD', 'North Texas Health Care Associates Endocrinology', 'Lalitha', '', 'Subramanyam', 'MD', 'Endocrinology', '', '', NULL, 'O', '2021 N MacArthur Blvd Ste 515', 'Irving', 'Dallas', 'TX', '75061', '9722593282', '9722592033', '2021 N MacArthur Blvd Ste 515', 'Irving', 'Dallas', 'TX', '75061', '9722593282', '9722592033', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1043476625', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.835, -96.9592, NULL, NULL),
('752536818', 'ELHT00034', 'ELHT00034', 'TXDALSTD', 'North Texas Health Care Associates Endocrinology', 'Lalitha', '', 'Subramanyam', 'MD', 'Endocrinology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1043476625', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00361', 'ELHT00361', 'TXDALSTD', 'Liver Consultants of Texas', 'Linsheng', '', 'Guo', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3410 Worth St Ste 860', 'Dallas', 'Dallas', 'TX', '75246', '2148208500', '2148208168', '3410 Worth St Ste 860', 'Dallas', 'Dallas', 'TX', '75246', '2148208500', '2148208168', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053365510', 0, 'N', 0, '2013-06-07', NULL, NULL, 32.7886, -96.779, NULL, NULL),
('752536818', 'ELHT00362', 'ELHT00362', 'TXDALSTD', 'Liver Consultants of Texas', 'Linsheng', '', 'Guo', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053365510', 0, 'N', 0, '2013-06-07', NULL, NULL, 0, 0, NULL, NULL),
('751837454', 'ELHT00701', 'ELHT00701', 'TXDALSTD', 'Health Texas Provider Network', 'Youcef', '', 'Sennour', 'MD', 'Geriatrics', '', '', NULL, 'O', '4004 Worth St Ste 100', 'Dallas', 'Dallas', 'TX', '75246', '2148206060', '2148206361', '4004 Worth St Ste 100', 'Dallas', 'Dallas', 'TX', '75246', '2148206060', '2148206361', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053369280', 0, 'Y', 0, '2013-08-07', NULL, NULL, 32.7913, -96.7758, NULL, NULL),
('751837454', 'ELHT00702', 'ELHT00702', 'TXDALSTD', 'Health Texas Provider Network', 'Youcef', '', 'Sennour', 'MD', 'Geriatrics', '', '', NULL, 'B', 'PO Box 844013', 'Dallas', 'Dallas', 'TX', '75284', '2148209480', '2148208995', 'PO Box 844013', 'Dallas', 'Dallas', 'TX', '75284', '2148209480', '2148208995', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053369280', 0, 'Y', 0, '2013-08-07', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00255', 'ELHT00255', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'John', 'B', 'Heinrich', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3900 Junius St Ste 500', 'Dallas', 'Dallas', 'TX', '75246', '2148237090', '2148231644', '3900 Junius St Ste 500', 'Dallas', 'Dallas', 'TX', '75246', '2148237090', '2148231644', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-05-31', 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1053526533', 0, 'N', 0, '2013-07-31', NULL, NULL, 32.7913, -96.7775, NULL, NULL),
('752536818', 'ELHT00256', 'ELHT00256', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'John', 'B', 'Heinrich', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'PO Box 844128  ', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1053526533', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00363', 'ELHT00363', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Ramey', '', 'Hito', 'DO', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave 4th floor', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1053544122', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00364', 'ELHT00364', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Ramey', '', 'Hito', 'DO', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1053544122', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752722718', 'ELHT00803', 'ELHT00803', 'TXDALSTD', 'Baylor Family Medical Center at Riverside', 'Guadalupe', '', 'Reyna', 'DO', 'Family Practice', '', '', NULL, 'O', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', 'HTPN', 'TXHCPCHTPN', NULL, '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053570226', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.797, -97.0554, NULL, NULL),
('752600832', 'ELHT00365', 'ELHT00365', 'TXDALSTD', 'MedProvider', 'Weldon', 'L', 'Smith', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 430', 'Dallas', 'Dallas', 'TX', '75204', '2148285000', '2148285031', '3434 Swiss Ave Ste 430', 'Dallas', 'Dallas', 'TX', '75204', '2148285000', '2148285031', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', 'Baylor Medical Center at Uptown', NULL, NULL, 'HCFA|UB|', '1063425155', 0, 'N', 0, '2013-06-14', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT00367', 'ELHT00367', 'TXDALSTD', 'McKinney Inpatient Care Unit', 'Sai', 'P', 'Haranath', 'MD', 'Hospitalist', '', '', NULL, 'O', '5252 W University Dr', 'McKinney', 'Collin', 'TX', '75071', '4697646950', '4697646954', '5252 W University Dr', 'McKinney', 'Collin', 'TX', '75071', '4697646950', '4697646954', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063446425', 0, 'Y', 0, '2013-05-01', NULL, NULL, 33.2183, -96.6841, NULL, NULL),
('752536818', 'ELHT00368', 'ELHT00368', 'TXDALSTD', 'McKinney Inpatient Care Unit', 'Sai', 'P', 'Haranath', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1063446425', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752722718', 'ELHT00805', 'ELHT00805', 'TXDALSTD', 'Baylor Family Medical Center at Riverside', 'Zachary', 'Q', 'Botone', 'MD', 'Family Practice', '', '', NULL, 'O', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', 'HTPN', 'TXHCPCHTPN', NULL, '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1063614337', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.797, -97.0554, NULL, NULL),
('752536818', 'ELHT00369', 'ELHT00369', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Srilakshmi', '', 'Chavali', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1063687259', 0, 'Y', 0, '2013-05-01', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00370', 'ELHT00370', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Srilakshmi', '', 'Chavali', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1063687259', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00807', 'ELHT00807', 'TXDALSTD', 'Baylor Family Health Center at Cityview', 'LaPonna', 'R', 'Irvine Moore', 'DO', 'Family Practice', '', '', NULL, 'O', '5701 Bryant Irvin Rd Ste 304', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173615030', '8173615031', '5701 Bryant Irvin Rd Ste 304', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173615030', '8173615031', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1063723260', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.6664, -97.4199, NULL, NULL),
('752536818', 'ELHT00808', 'ELHT00808', 'TXDALSTD', 'Baylor Family Health Center at Cityview', 'LaPonna', 'R', 'Irvine Moore', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1063723260', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('030374787', 'ELHT00717', 'ELHT00717', 'TXDALSTD', 'Surgical Institute', 'Jill', 'S', 'Stephenson', 'MD', 'General Surgery', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 958', 'Dallas', 'Dallas', 'TX', '75246', '2148266276', '2148266223', '3600 Gaston Ave Wadley Tower Ste 958', 'Dallas', 'Dallas', 'TX', '75246', '2148266276', '2148266223', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1073521886', 0, 'N', 0, '2013-05-22', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00201', 'ELHT00201', 'TXDALSTD', 'City Square Community Health Services', 'Rhonda', 'L', 'Walton', 'MD', 'Pediatrics', '', '', NULL, 'O', '2835 Grand Ave', 'Dallas', 'Dallas', 'TX', '75215', '2148238710', '2148213282', '2835 Grand Ave', 'Dallas', 'Dallas', 'TX', '75215', '2148238710', '2148213282', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073559365', 0, 'N', 0, '2013-05-01', NULL, NULL, 32.7723, -96.7708, NULL, NULL),
('752536818', 'ELHT00202', 'ELHT00202', 'TXDALSTD', 'City Square Community Health Services', 'Rhonda', 'L', 'Walton', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073559365', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00809', 'ELHT00809', 'TXDALSTD', 'Baylor Family Medicine at Prosper', 'Kelly', 'E', 'Phillips', 'DO', 'Family Practice', '', '', NULL, 'O', '821 N Coleman Ste 100', 'Prosper', 'Collin', 'TX', '75078', '4698005200', '4698005210', '821 North Coleman Ste 100', 'Prosper', 'Collin', 'TX', '75078', '4698005200', '4698005210', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073593349', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.2385, -96.8032, NULL, NULL),
('752536818', 'ELHT00810', 'ELHT00810', 'TXDALSTD', 'Baylor Family Medicine at Prosper', 'Kelly', 'E', 'Phillips', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073593349', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00811', 'ELHT00811', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Valerie', 'A', 'Peterson', 'MD', 'Family Practice', '', '', NULL, 'O', '1575 I-30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', '1575 I 30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1073636304', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8297, -96.6193, NULL, NULL),
('752536818', 'ELHT00812', 'ELHT00812', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Valerie', 'A', 'Peterson', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1073636304', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01117', 'ELHT01117', 'TXDALSTD', 'Legacy Heart Group', 'John', 'S', 'Hollowell', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1083601520', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0625, -96.7963, NULL, NULL),
('752536818', 'ELHT01118', 'ELHT01118', 'TXDALSTD', 'Legacy Heart Group', 'John', 'S', 'Hollowell', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1083601520', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00257', 'ELHT00257', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'Virgil', 'B', 'Medlock', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '7777 Forest Ln Ste C106', 'Dallas', 'Dallas', 'TX', '75230', '2148237090', '2148231644', '7777 Forest Ln Ste C106', 'Dallas', 'Dallas', 'TX', '75230', '2148237090', '2148231644', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-05-31', 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1083604458', 0, 'N', 0, '2013-07-31', NULL, NULL, 32.9114, -96.7743, NULL, NULL),
('752536818', 'ELHT00258', 'ELHT00258', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'Virgil', 'B', 'Medlock', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'PO Box 844128  ', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1083604458', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00167', 'ELHT00167', 'TXDALSTD', 'Physiatric Medicine Associates', 'Rosemary', 'A', 'Dubiel', 'DO', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '909 N Washington Ave', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', '909 N Washington', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1083622732', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7918, -96.7791, NULL, NULL),
('752536818', 'ELHT00168', 'ELHT00168', 'TXDALSTD', 'Physiatric Medicine Associates', 'Rosemary', 'A', 'Dubiel', 'DO', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1083622732', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00371', 'ELHT00371', 'TXDALSTD', 'Dallas Diagnostic Association Garland', 'Gary', 'V', 'Hoss', 'MD', 'Internal Medicine', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 300', 'Garland', 'Dallas', 'TX', '75042', '4698002000', '9722722073', '601 Clara Barton Blvd Ste 300', 'Garland', 'Dallas', 'TX', '75042', '4698002000', '9722722073', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1083642714', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00372', 'ELHT00372', 'TXDALSTD', 'Dallas Diagnostic Association Garland', 'Gary', 'V', 'Hoss', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1083642714', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00813', 'ELHT00813', 'TXDALSTD', '', 'Robert', 'L', 'Andersen', 'MD', 'Family Practice', '', '', NULL, 'O', '5345 N George Bush Fwy', 'Garland', 'Dallas', 'TX', '75040', '9724955888', '9724950588', '5345 N George Bush Fwy', 'Garland', 'Dallas', 'TX', '75040', '9724955888', '9724950588', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, '', NULL, 'HCFA|UB|', '1083647812', 0, 'N', 0, '2014-01-30', NULL, NULL, 32.9651, -96.6418, NULL, NULL),
('752536818', 'ELHT00814', 'ELHT00814', 'TXDALSTD', '', 'Robert', 'L', 'Andersen', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, '', NULL, 'HCFA|UB|', '1083647812', 0, 'Y', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00815', 'ELHT00815', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Matthew', 'C', 'Moreland', 'DO', 'Family Practice', '', '', NULL, 'O', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '9727231474', '9727239423', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '9727231474', '9727239423', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1083681381', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.4671, -96.9768, NULL, NULL),
('911947573', 'ELHT00816', 'ELHT00816', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Matthew', 'C', 'Moreland', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1083681381', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00719', 'ELHT00719', 'TXDALSTD', 'Surgical Oncology Specialists', 'Christine', 'S', 'Landry', 'MD', 'General Surgery', '', '', NULL, 'O', '3410 Worth St Ste 235', 'Dallas', 'Dallas', 'TX', '75246', '2148202302', '2148202303', '3410 Worth St Ste 235', 'Dallas', 'Dallas', 'TX', '75246', '2148202302', '2148202303', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1083742662', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7886, -96.779, NULL, NULL),
('911947573', 'ELHT00720', 'ELHT00720', 'TXDALSTD', 'Surgical Oncology Specialists', 'Christine', 'S', 'Landry', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208612', '2148202303', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208612', '2148202303', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1083742662', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('751837454', 'ELHT00373', 'ELHT00373', 'TXDALSTD', 'Health Texas Provider Network', 'Wilson', '', 'Weatherford', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3504 Swiss Ave', 'Dallas', 'Dallas', 'TX', '75204', '2148209764', '2148209705', '3504 Swiss Ave', 'Dallas', 'Dallas', 'TX', '75204', '2148209764', '2148209705', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1093739963', 0, 'N', 0, '2013-08-07', NULL, NULL, 32.7918, -96.7821, NULL, NULL),
('751837454', 'ELHT00374', 'ELHT00374', 'TXDALSTD', 'Health Texas Provider Network', 'Wilson', '', 'Weatherford', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844013', 'Dallas', 'Dallas', 'TX', '75284', '2148209480', '2148208995', 'PO Box 844013', 'Dallas', 'Dallas', 'TX', '75284', '2148209480', '2148208995', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1093739963', 0, 'N', 0, '2013-08-07', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00203', 'ELHT00203', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Waxahachie', 'Travis', 'S', 'Henry', 'MD', 'Pediatrics', '', '', NULL, 'O', '505 N Hwy 77 Ste 200', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231686', '9729377731', '505 N Hwy 77 Ste 200', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231686', '9729377731', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1093743569', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.3965, -96.8453, NULL, NULL),
('911947573', 'ELHT00204', 'ELHT00204', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Waxahachie', 'Travis', 'S', 'Henry', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1093743569', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00753', 'ELHT00753', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Shibu', 'G', 'Oommen', 'MD', 'Gastroenterology', '', '', NULL, 'O', '4708 Alliance Blvd Ste 200', 'Plano', 'Collin', 'TX', '75093', '4698006020', '4698006001', '4708 Alliance Blvd Ste 200', 'Plano', 'Collin', 'TX', '75093', '4698006020', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1093751695', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00754', 'ELHT00754', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Shibu', 'G', 'Oommen', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1093751695', 0, 'Y', 0, '2014-01-08', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00169', 'ELHT00169', 'TXDALSTD', 'Physiatric Medicine Associates', 'David', 'C', 'Lo', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '2001 N MacArthur Blvd Ste 335', 'Irving', 'Dallas', 'TX', '75061', '9722546022', '9722533242', '2001 N MacArthur Blvd Ste 335', 'Irving', 'Dallas', 'TX', '75061', '9722546022', '9722533242', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1093769820', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8349, -96.9592, NULL, NULL),
('752536818', 'ELHT00170', 'ELHT00170', 'TXDALSTD', 'Physiatric Medicine Associates', 'David', 'C', 'Lo', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1093769820', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00817', 'ELHT00817', 'TXDALSTD', 'Baylor Family Health Center at Cityview', 'Caroline', 'E', 'Woodland', 'DO', 'Family Practice', '', '', NULL, 'O', '5701 Bryant Irvin Rd Ste 304', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173615030', '8173615031', '5701 Bryant Irvin Rd Ste 304', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173615030', '8173615031', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093771842', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.6664, -97.4199, NULL, NULL),
('752536818', 'ELHT00818', 'ELHT00818', 'TXDALSTD', 'Baylor Family Health Center at Cityview', 'Caroline', 'E', 'Woodland', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093771842', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00375', 'ELHT00375', 'TXDALSTD', 'Plano IPCU', 'Deepa', 'R', 'Moparty', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1093914962', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0144, -96.7924, NULL, NULL),
('752582845', 'ELHT00376', 'ELHT00376', 'TXDALSTD', 'Plano IPCU', 'Deepa', 'R', 'Moparty', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1093914962', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00377', 'ELHT00377', 'TXDALSTD', 'Health Texas Provider Network', 'Rui', 'C', 'Benevides', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1093973216', 0, 'N', 0, '2013-08-27', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00378', 'ELHT00378', 'TXDALSTD', 'Health Texas Provider Network', 'Rui', 'C', 'Benevides', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1093973216', 0, 'N', 0, '2013-08-27', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01101', 'ELHT01101', 'TXDALSTD', 'Dermatology Specialists of McKinney', 'Jonathan', 'D', 'Richey', 'DO', 'Dermatology', '', '', NULL, 'O', '5236 W University Dr Ste 2200', 'McKinney', 'Collin', 'TX', '75071', '4698005000', '4698005010', '5236 W University Dr Ste 2200', 'McKinney', 'Collin', 'TX', '75071', '4698005000', '4698005010', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, '', '', 'HCFA|UB|', '1104085216', 0, 'N', 0, '2013-09-30', NULL, NULL, 33.2183, -96.684, NULL, NULL),
('752536818', 'ELHT01102', 'ELHT01102', 'TXDALSTD', 'Dermatology Specialists of McKinney', 'Jonathan', 'D', 'Richey', 'DO', 'Dermatology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, '', '', 'HCFA|UB|', '1104085216', 0, 'Y', 0, '2013-09-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00819', 'ELHT00819', 'TXDALSTD', 'Colleyville Family Medicine', 'Kathryn', 'S', 'Byrd', 'DO', 'Family Practice', '', '', NULL, 'O', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104811850', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8864, -97.1519, NULL, NULL),
('752536818', 'ELHT00820', 'ELHT00820', 'TXDALSTD', 'Colleyville Family Medicine', 'Kathryn', 'S', 'Byrd', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104811850', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00001', 'ELHT00001', 'TXDALSTD', 'Cottonwood Cardiology', 'Ali', 'M', 'Kizilbash', 'MD', 'Cardiology', '', '', NULL, 'O', '1110 Cottonwood Ln Ste 105', 'Irving', 'Dallas', 'TX', '75038', '9726072525', '9722528837', '1110 Cottonwood Ln Ste 105', 'Irving', 'Dallas', 'TX', '75038', '9726072525', '9722528837', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1104825090', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8652, -96.9601, NULL, NULL),
('752536818', 'ELHT00002', 'ELHT00002', 'TXDALSTD', 'Cottonwood Cardiology', 'Ali', 'M', 'Kizilbash', 'MD', 'Cardiology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1104825090', 0, 'Y', 0, '2013-03-13', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00821', 'ELHT00821', 'TXDALSTD', 'Family Medical Center at Garland', 'Becky', 'L', 'Chandler', 'MD', 'Family Practice', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 140', 'Garland', 'Dallas', 'TX', '75042', '9722726561', '9722763067', '601 Clara Barton Blvd Ste 140', 'Garland', 'Dallas', 'TX', '75042', '9722726561', '9722763067', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1104848589', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00822', 'ELHT00822', 'TXDALSTD', 'Family Medical Center at Garland', 'Becky', 'L', 'Chandler', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1104848589', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00823', 'ELHT00823', 'TXDALSTD', 'Baylor Occupational and Family Health Center', 'Kirat', 'S', 'Ghosh', 'MD', 'Family Practice', '', '', NULL, 'O', '13350 Ti Blvd Ste MS327', 'Dallas', 'Dallas', 'TX', '75243', '9726719504', '9726717096', '13350 TI Blvd MS 327', 'Dallas', 'Dallas', 'TX', '75243', '9726719504', '9726717096', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104854926', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9284, -96.749, NULL, NULL),
('752536818', 'ELHT00824', 'ELHT00824', 'TXDALSTD', 'Baylor Occupational and Family Health Center', 'Kirat', 'S', 'Ghosh', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104854926', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00379', 'ELHT00379', 'TXDALSTD', '', 'Xiaying', 'S', 'Zhu', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1104854975', 0, 'N', 0, '2014-01-24', NULL, NULL, 32.3968, -96.865, NULL, NULL),
('911947573', 'ELHT00380', 'ELHT00380', 'TXDALSTD', '', 'Xiaying', 'S', 'Zhu', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1104854975', 0, 'N', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00825', 'ELHT00825', 'TXDALSTD', 'Baylor Family Medicine at Frankford and Josey', 'Phillip', 'H', 'Disraeli', 'MD', 'Family Practice', '', '', NULL, 'O', '1933 E Frankford Rd Ste 100', 'Carrollton', 'Denton', 'TX', '75007', '4698001100', '4698001110', '1933 E Frankford Rd Ste 100', 'Carrollton', 'Denton', 'TX', '75007', '4698001100', '4698001110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, '', NULL, 'HCFA|UB|', '1104858380', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0002, -96.8844, NULL, NULL),
('752536818', 'ELHT00826', 'ELHT00826', 'TXDALSTD', 'Baylor Family Medicine at Frankford and Josey', 'Phillip', 'H', 'Disraeli', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, '', NULL, 'HCFA|UB|', '1104858380', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911982510', 'ELHT00827', 'ELHT00827', 'TXDALSTD', 'Family Medical Center at Terrell', 'William', 'J', 'Fieldsmith', 'MD', 'Family Practice', '', '', NULL, 'O', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114126703', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7372, -96.2749, NULL, NULL),
('911982510', 'ELHT00828', 'ELHT00828', 'TXDALSTD', 'Family Medical Center at Terrell', 'William', 'J', 'Fieldsmith', 'MD', 'Family Practice', '', '', NULL, 'B', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114126703', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00381', 'ELHT00381', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Frederick', 'G', 'Tinio', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave 4th floor', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1114902111', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00382', 'ELHT00382', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Frederick', 'G', 'Tinio', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1114902111', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00121', 'ELHT00121', 'TXDALSTD', 'Metroplex Surgical Specialists', 'David', 'L', 'Gould', 'MD', 'Urology', '', '', NULL, 'O', '1420 8th Ave Ste 101', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179200130', '8179209953', '1420 8th Ave Ste 101', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179200130', '8179209953', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114968625', 0, 'N', 0, '2013-12-09', NULL, NULL, 32.7298, -97.3444, NULL, NULL),
('752536818', 'ELHT00122', 'ELHT00122', 'TXDALSTD', 'Metroplex Surgical Specialists', 'David', 'L', 'Gould', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114968625', 0, 'N', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00829', 'ELHT00829', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'David', 'B', 'Lensch', 'MD', 'Family Practice', '', '', NULL, 'O', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114976453', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8645, -96.4413, NULL, NULL),
('752536818', 'ELHT00830', 'ELHT00830', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'David', 'B', 'Lensch', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114976453', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00171', 'ELHT00171', 'TXDALSTD', 'Physiatric Medicine Associates', 'Evangeline', 'T', 'Cayton', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '411 N Washington Ave Ste 4000', 'Dallas', 'Dallas', 'TX', '75246', '2148202521', '2148201654', '411 N Washington Ave Ste 4000', 'Dallas', 'Dallas', 'TX', '75246', '2148202521', '2148201654', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124033964', 0, 'N', 0, '2013-07-30', NULL, NULL, 32.7888, -96.7763, NULL, NULL),
('752536818', 'ELHT00172', 'ELHT00172', 'TXDALSTD', 'Physiatric Medicine Associates', 'Evangeline', 'T', 'Cayton', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1124033964', 0, 'N', 0, '2013-07-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00173', 'ELHT00173', 'TXDALSTD', 'Physiatric Medicine Associates', 'Milton', 'D', 'Thomas', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '909 N Washington Ave', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', '909 N Washington Ave', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2014-05-21', 0, 0, 0, 'Baylor University Medical Center', '', '', '', 'HCFA|UB|', '1124037551', 0, 'N', 0, '2014-05-21', NULL, NULL, 32.7918, -96.7791, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('752536818', 'ELHT00174', 'ELHT00174', 'TXDALSTD', 'Physiatric Medicine Associates', 'Milton', 'D', 'Thomas', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2014-05-21', 0, 0, 0, 'Baylor University Medical Center', '', '', '', 'HCFA|UB|', '1124037551', 0, 'N', 0, '2014-05-21', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00383', 'ELHT00383', 'TXDALSTD', 'Plano IPCU', 'David', 'A', 'Strawman', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1124067871', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0144, -96.7924, NULL, NULL),
('752582845', 'ELHT00384', 'ELHT00384', 'TXDALSTD', 'Plano IPCU', 'David', 'A', 'Strawman', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1124067871', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00385', 'ELHT00385', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Richard', 'C', 'Chen', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1124131412', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00386', 'ELHT00386', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Richard', 'C', 'Chen', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1124131412', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00293', 'ELHT00293', 'TXDALSTD', 'Garland OB-Gyn Associates', 'Kathryn', 'R', 'Brown', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 160', 'Garland', 'Dallas', 'TX', '75042', '4698002240', '9724858769', '601 Clara Barton Blvd Ste 160', 'Garland', 'Dallas', 'TX', '75042', '4698002240', '9724858769', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2014-02-14', 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1124248083', 0, 'N', 0, '2014-03-20', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00294', 'ELHT00294', 'TXDALSTD', 'Garland OB-Gyn Associates', 'Kathryn', 'R', 'Brown', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2014-02-14', 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1124248083', 0, 'N', 0, '2014-03-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00831', 'ELHT00831', 'TXDALSTD', 'Baylor Community Care at Worth Street', 'Scott', '', 'Wang', 'MD', 'Family Practice', '', '', NULL, 'O', '4001 Worth St', 'Dallas', 'Dallas', 'TX', '75246', '2148281745', '2148281734', '4001 Worth St', 'Dallas', 'Dallas', 'TX', '75246', '2148281745', '2148281734', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1124297155', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7912, -96.7759, NULL, NULL),
('752536818', 'ELHT00832', 'ELHT00832', 'TXDALSTD', 'Baylor Community Care at Worth Street', 'Scott', '', 'Wang', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1124297155', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01119', 'ELHT01119', 'TXDALSTD', 'Legacy Heart Group', 'Radhakrishnan', 'K', 'Nair', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1134116676', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0625, -96.7963, NULL, NULL),
('752536818', 'ELHT01120', 'ELHT01120', 'TXDALSTD', 'Legacy Heart Group', 'Radhakrishnan', 'K', 'Nair', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1134116676', 0, 'Y', 0, '2013-04-05', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00387', 'ELHT00387', 'TXDALSTD', 'MedProvider', 'Roger', 'S', 'Khetan', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 205', 'Dallas', 'Dallas', 'TX', '75204', '2148285070', '2148285071', '3434 Swiss Ave Ste 205', 'Dallas', 'Dallas', 'TX', '75204', '2148285070', '2148285071', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1134143134', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT00833', 'ELHT00833', 'TXDALSTD', 'Colleyville Family Medicine', 'Margaret', '', 'Walter', 'DO', 'Family Practice', '', '', NULL, 'O', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134157829', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8864, -97.1519, NULL, NULL),
('752536818', 'ELHT00834', 'ELHT00834', 'TXDALSTD', 'Colleyville Family Medicine', 'Margaret', '', 'Walter', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134157829', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00721', 'ELHT00721', 'TXDALSTD', 'Metroplex Surgical Specialists', 'Michael', 'L', 'Green', 'MD', 'General Surgery', '', '', NULL, 'O', '1420 8th Ave Ste 101', 'Ft Worth', 'Tarrant', 'TX', '76104', '8172079775', '8179201786', '1420 8th Ave Ste 101', 'Ft Worth', 'Tarrant', 'TX', '76104', '8172079775', '8179201786', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1134165566', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7283, -97.3437, NULL, NULL),
('752536818', 'ELHT00722', 'ELHT00722', 'TXDALSTD', 'Metroplex Surgical Specialists', 'Michael', 'L', 'Green', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1134165566', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00835', 'ELHT00835', 'TXDALSTD', '', 'Wesley', 'G', 'Acker', 'MD', 'Family Practice', '', '', NULL, 'O', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134178452', 0, 'N', 0, '2014-01-30', NULL, NULL, 32.8645, -96.4413, NULL, NULL),
('752536818', 'ELHT00836', 'ELHT00836', 'TXDALSTD', '', 'Wesley', 'G', 'Acker', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134178452', 0, 'Y', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00389', 'ELHT00389', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Vijayavalli', '', 'Little', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1134306590', 0, 'Y', 0, '2013-05-01', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00390', 'ELHT00390', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Vijayavalli', '', 'Little', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1134306590', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00391', 'ELHT00391', 'TXDALSTD', 'MedProvider', 'Michael', 'T', 'Johnston', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 420', 'Dallas', 'Dallas', 'TX', '75204', '2148285000', '2148285021', '3434 Swiss Ave Ste 420', 'Dallas', 'Dallas', 'TX', '75204', '2148285000', '2148285021', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144232265', 0, 'N', 0, '2013-06-14', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752600832', 'ELHT00393', 'ELHT00393', 'TXDALSTD', 'MedProvider', 'David', 'Michael', 'Highbaugh', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 310', 'Dallas', 'Dallas', 'TX', '75204', '2148285050', '2148285051', '3434 Swiss Ave Ste 310', 'Dallas', 'Dallas', 'TX', '75204', '2148285050', '2148285051', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144232414', 0, 'N', 0, '2013-04-05', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('911947573', 'ELHT00259', 'ELHT00259', 'TXDALSTD', 'Orthopaedic Trauma Associates of North Texas', 'Randall', 'L', 'Lais', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3409 Worth St Ste 300', 'Dallas', 'Dallas', 'TX', '75246', '2148208350', '2148208355', '3409 Worth St Ste 300', 'Dallas', 'Dallas', 'TX', '75246', '2148208350', '2148208355', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1144258443', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7886, -96.779, NULL, NULL),
('911947573', 'ELHT00260', 'ELHT00260', 'TXDALSTD', 'Orthopaedic Trauma Associates of North Texas', 'Randall', 'L', 'Lais', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1144258443', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00205', 'ELHT00205', 'TXDALSTD', 'Pediatric and Adolescent Associates of Garland', 'Robert', 'A', 'Kotas', 'MD', 'Pediatrics', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 250', 'Garland', 'Dallas', 'TX', '75042', '9722727887', '9722727992', '601 Clara Barton Blvd Ste 250', 'Garland', 'Dallas', 'TX', '75042', '9722727887', '9722727992', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1144265240', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00206', 'ELHT00206', 'TXDALSTD', 'Pediatric and Adolescent Assoc of Garland', 'Robert', 'A', 'Kotas', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1144265240', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00125', 'ELHT00125', 'TXDALSTD', 'Cardiovascular Surgical Specialists of Irving', 'Jose', 'F', 'Escobar', 'MD', 'Thoracic Surgery', '', '', NULL, 'O', '1110 Cottonwood Ln Ste 215', 'Irving', 'Dallas', 'TX', '75038', '9722594781', '4694177947', '1110 Cottonwood Ln Ste 215', 'Irving', 'Dallas', 'TX', '75038', '9722594781', '4694177947', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1144424920', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8652, -96.9601, NULL, NULL),
('752536818', 'ELHT00126', 'ELHT00126', 'TXDALSTD', 'Cardiovascular Surgical Specialists of Irving', 'Jose', 'F', 'Escobar', 'MD', 'Thoracic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1144424920', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00837', 'ELHT00837', 'TXDALSTD', 'Health Texas Provider Network', 'Oscar', '', 'De Leon', 'MD', 'Family Practice', '', '', NULL, 'O', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-10', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144482936', 0, 'N', 0, '2013-07-03', NULL, NULL, 32.3961, -96.864, NULL, NULL),
('911947573', 'ELHT00838', 'ELHT00838', 'TXDALSTD', 'Health Texas Provider Network', 'Oscar', '', 'De Leon', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-10', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144482936', 0, 'Y', 0, '2013-07-03', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01121', 'ELHT01121', 'TXDALSTD', 'Legacy Heart Group', 'Samuel', 'C', 'Woolbert', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1154318681', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0625, -96.7963, NULL, NULL),
('752536818', 'ELHT01122', 'ELHT01122', 'TXDALSTD', 'Legacy Heart Group', 'Samuel', 'C', 'Woolbert', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1154318681', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00061', 'ELHT00061', 'TXDALSTD', 'Supportive and Palliative Care Clinic at BUMC', 'Mark', 'Andrew', 'Casanova', 'MD', 'Hospice', '', '', NULL, 'O', '3600 Gaston Ave Barnett Tower Ste 605', 'Dallas', 'Dallas', 'TX', '75246', '2148209248', '2148209458', '3600 Gaston Ave Barnett Tower Ste 605', 'Dallas', 'Dallas', 'TX', '75246', '2148209248', '2148209458', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154332088', 0, 'Y', 0, '2013-04-05', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00062', 'ELHT00062', 'TXDALSTD', 'Supportive and Palliative Care Clinic at BUMC', 'Mark', 'Andrew', 'Casanova', 'MD', 'Hospice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154332088', 0, 'N', 0, '2013-04-05', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00395', 'ELHT00395', 'TXDALSTD', 'Plano IPCU', 'James', 'A', 'Fojt', 'DO', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1154340701', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0144, -96.7924, NULL, NULL),
('752582845', 'ELHT00396', 'ELHT00396', 'TXDALSTD', 'Plano IPCU', 'James', 'A', 'Fojt', 'DO', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1154340701', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00397', 'ELHT00397', 'TXDALSTD', 'Internal Medicine Associates at Irving', 'Robert', 'W', 'Israel', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2021 N MacArthur Blvd Ste 520', 'Irving', 'Dallas', 'TX', '75061', '9722512388', '9722512390', '2021 N MacArthur Blvd Ste 520', 'Irving', 'Dallas', 'TX', '75061', '9722512388', '9722512390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1154347227', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.835, -96.9592, NULL, NULL),
('752536818', 'ELHT00398', 'ELHT00398', 'TXDALSTD', 'Internal Medicine Associates at Irving', 'Robert', 'W', 'Israel', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1154347227', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00399', 'ELHT00399', 'TXDALSTD', '', 'Charles', 'F', 'Natalizio', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1154357523', 0, 'N', 0, '2014-01-24', NULL, NULL, 32.3968, -96.865, NULL, NULL),
('911947573', 'ELHT00400', 'ELHT00400', 'TXDALSTD', '', 'Charles', 'F', 'Natalizio', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1154357523', 0, 'N', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01103', 'ELHT01103', 'TXDALSTD', 'Modern Dermatology', 'Jennifer', 'C', 'Cather', 'MD', 'Dermatology', '', '', NULL, 'O', '9101 N Central Expwy Ste 150', 'Dallas', 'Dallas', 'TX', '75231', '2142651818', '2142651806', '9101 N Central Expy Ste 150', 'Dallas', 'Dallas', 'TX', '75231', '2142651818', '2142651806', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1154366417', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT01104', 'ELHT01104', 'TXDALSTD', 'Modern Dermatology', 'Jennifer', 'C', 'Cather', 'MD', 'Dermatology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1154366417', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00009', 'ELHT00009', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Jeffrey', 'C', 'Lilly', 'MD', 'Critical Care', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1154423911', 0, 'Y', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00010', 'ELHT00010', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Jeffrey', 'C', 'Lilly', 'MD', 'Critical Care', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1154423911', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00401', 'ELHT00401', 'TXDALSTD', 'MedProvider', 'Cherese', 'M', 'Wiley', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 206', 'Dallas', 'Dallas', 'TX', '75204', '2148285660', '2148285659', '3434 Swiss Ave Ste 206', 'Dallas', 'Dallas', 'TX', '75204', '2148285660', '2148285659', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1154527513', 0, 'N', 0, '2013-06-14', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT00207', 'ELHT00207', 'TXDALSTD', 'North Texas Health Care Associates Pediatrics', 'Anand', 'D', 'Bhatt', 'MD', 'Pediatrics', '', '', NULL, 'O', '400 W IH 635 Ste 250', 'Irving', 'Dallas', 'TX', '75063', '9724816400', '9728319794', '400 W IH 635 Ste 250', 'Irving', 'Dallas', 'TX', '75063', '9724816400', '9728319794', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, '', NULL, 'HCFA|UB|', '1164447579', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9125, -96.9492, NULL, NULL),
('752536818', 'ELHT00208', 'ELHT00208', 'TXDALSTD', 'North Texas Health Care Associates Pediatrics', 'Anand', 'D', 'Bhatt', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, '', NULL, 'HCFA|UB|', '1164447579', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00839', 'ELHT00839', 'TXDALSTD', 'Family Medical Center at North Garland', 'David', 'W', 'Bragg', 'MD', 'Family Practice', '', '', NULL, 'O', '5345 N George Bush Fwy', 'Garland', 'Dallas', 'TX', '75040', '9724955888', '9724950588', '5345 N George Bush Fwy', 'Garland', 'Dallas', 'TX', '75040', '9724955888', '9724950588', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, '', NULL, 'HCFA|UB|', '1164453874', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9651, -96.6418, NULL, NULL),
('752536818', 'ELHT00840', 'ELHT00840', 'TXDALSTD', 'Family Medical Center at North Garland', 'David', 'W', 'Bragg', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, '', NULL, 'HCFA|UB|', '1164453874', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00403', 'ELHT00403', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Leigh', 'F', 'Nordstrom', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '9727231474', '9727239423', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '9727231474', '9727239423', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1164465316', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.4671, -96.9768, NULL, NULL),
('911947573', 'ELHT00404', 'ELHT00404', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Leigh', 'F', 'Nordstrom', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1164465316', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00153', 'ELHT00153', 'TXDALSTD', '', 'Wassila', '', 'Amari', 'MD', 'Rheumatology', '', '', NULL, 'O', '9101 N Central Expwy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', '9101 N Central Expwy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164468088', 0, 'N', 0, '2014-01-30', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00154', 'ELHT00154', 'TXDALSTD', '', 'Wassila', '', 'Amari', 'MD', 'Rheumatology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164468088', 0, 'N', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00841', 'ELHT00841', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'James', 'G', 'Muns', 'MD', 'Family Practice', '', '', NULL, 'O', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164471389', 0, 'N', 0, '2013-07-30', NULL, NULL, 32.8649, -96.4407, NULL, NULL),
('752536818', 'ELHT00842', 'ELHT00842', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'James', 'G', 'Muns', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164471389', 0, 'Y', 0, '2013-07-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00405', 'ELHT00405', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Safia', '', 'Raza', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1164673893', 0, 'Y', 0, '2013-05-01', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00406', 'ELHT00406', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Safia', '', 'Raza', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1164673893', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00843', 'ELHT00843', 'TXDALSTD', 'Baylor Family Medicine at Lake Ridge', 'Crystal', 'R', 'Foster', 'MD', 'Family Practice', '', '', NULL, 'O', '4927 Lake Ridge Pkwy Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75052', '9726419000', '9726419002', '4927 Lake Ridge Pkwy Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75052', '9726419000', '9726419002', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1164697850', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.6594, -97.037, NULL, NULL),
('752536818', 'ELHT00844', 'ELHT00844', 'TXDALSTD', 'Baylor Family Medicine at Lake Ridge', 'Crystal', 'R', 'Foster', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1164697850', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00035', 'ELHT00035', 'TXDALSTD', 'Endocrinology Specialists of Dallas', 'Maryam', '', 'Zamanian', 'MD', 'Endocrinology', '', '', NULL, 'O', '3600 Gaston Ave Ste 656', 'Dallas', 'Dallas', 'TX', '75246', '9729986711', '2148208944', '3600 Gaston Ave Ste 656', 'Dallas', 'Dallas', 'TX', '75246', '9729986711', '2148208944', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', '', 'HCFA|UB|', '1174508311', 0, 'N', 0, '2013-05-01', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00036', 'ELHT00036', 'TXDALSTD', 'Endocrinology Specialists of Dallas', 'Maryam', '', 'Zamanian', 'MD', 'Endocrinology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', '', 'HCFA|UB|', '1174508311', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01189', 'ELHT01189', 'TXDALSTD', 'Legacy Heart Group', 'Patrick', 'L', 'Kennedy', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1174571137', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0625, -96.7963, NULL, NULL),
('752536818', 'ELHT01190', 'ELHT01190', 'TXDALSTD', 'Legacy Heart Group', 'Patrick', 'L', 'Kennedy', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1174571137', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00845', 'ELHT00845', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'Jennifer', 'M', 'Miller', 'MD', 'Family Practice', '', '', NULL, 'O', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174572903', 0, 'N', 0, '2013-07-30', NULL, NULL, 32.8649, -96.4407, NULL, NULL),
('752536818', 'ELHT00846', 'ELHT00846', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'Jennifer', 'M', 'Miller', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1174572903', 0, 'Y', 0, '2013-07-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00037', 'ELHT00037', 'TXDALSTD', 'Baylor Endocrine Center', 'Erin', 'D', 'Roe', 'MD', 'Endocrinology', '', '', NULL, 'O', '3600 Gaston Ave Ste 656', 'Dallas', 'Dallas', 'TX', '75246', '2148203466', '2148208944', '3600 Gaston Ave Ste 656', 'Dallas', 'Dallas', 'TX', '75246', '2148203466', '2148208944', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1174726590', 0, 'N', 0, '2013-05-01', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00038', 'ELHT00038', 'TXDALSTD', 'Baylor Endocrine Center', 'Erin', 'D', 'Roe', 'MD', 'Endocrinology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1174726590', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01123', 'ELHT01123', 'TXDALSTD', 'Legacy Heart Group', 'Jose', 'M', 'Rivera', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1184611626', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0625, -96.7963, NULL, NULL),
('752536818', 'ELHT01124', 'ELHT01124', 'TXDALSTD', 'Legacy Heart Group', 'Jose', 'M', 'Rivera', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1184611626', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00407', 'ELHT00407', 'TXDALSTD', 'Health Texas Provider Network', 'Jeffrey', 'S', 'Austin', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2021 N MacArthur Blvd Ste 520', 'Irving', 'Dallas', 'TX', '75061', '9722512388', '9722512390', '2021 N MacArthur Blvd Ste 520', 'Irving', 'Dallas', 'TX', '75061', '9722512388', '9722512390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1184649824', 0, 'N', 0, '2013-06-07', NULL, NULL, 32.835, -96.9592, NULL, NULL),
('752536818', 'ELHT00408', 'ELHT00408', 'TXDALSTD', 'Health Texas Provider Network', 'Jeffrey', 'S', 'Austin', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1184649824', 0, 'N', 0, '2013-06-07', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00847', 'ELHT00847', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Red Oak', 'James', 'L', 'Thomison', 'MD', 'Family Practice', '', '', NULL, 'O', '301 E Ovilla Rd Ste 100', 'Red Oak', 'Ellis', 'TX', '75154', '9726175225', '9726177922', '301 E Ovilla Rd Ste 100', 'Red Oak', 'Ellis', 'TX', '75154', '9726175225', '9726177922', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184660839', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.5318, -96.8051, NULL, NULL),
('911947573', 'ELHT00848', 'ELHT00848', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Red Oak', 'James', 'L', 'Thomison', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184660839', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00067', 'ELHT00067', 'TXDALSTD', 'Baylor Neurosurgery Associates', 'Richard', 'C', 'Naftalis', 'MD', 'Neurosurgery', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 1158', 'Dallas', 'Dallas', 'TX', '75246', '2148208585', '2148208590', '3600 Gaston Ave Wadley Ste 1158', 'Dallas', 'Dallas', 'TX', '75246', '2148208585', '2148208590', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184666737', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('911947573', 'ELHT00068', 'ELHT00068', 'TXDALSTD', 'Baylor Neurosurgery Associates', 'Richard', 'C', 'Naftalis', 'MD', 'Neurosurgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208612', '2148208614', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208612', '2148208614', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184666737', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00755', 'ELHT00755', 'TXDALSTD', 'Dallas Diagnostic Association McKinney', 'Praveen', 'R', 'Srungaram', 'MD', 'Gastroenterology', '', '', NULL, 'O', '5236 W University Dr Ste 2200', 'McKinney', 'Collin', 'TX', '75071', '4698005375', '4698005010', '5236 W University Dr Ste 2200', 'McKinney', 'Collin', 'TX', '75071', '4698005375', '4698005010', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1184715781', 0, 'N', 0, '2013-09-30', NULL, NULL, 33.2183, -96.684, NULL, NULL),
('752582845', 'ELHT00756', 'ELHT00756', 'TXDALSTD', 'Dallas Diagnostic Association McKinney', 'Praveen', 'R', 'Srungaram', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1184715781', 0, 'Y', 0, '2013-09-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01125', 'ELHT01125', 'TXDALSTD', 'The Heart Group', 'David', 'L', 'Brown', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1194717348', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('752536818', 'ELHT01126', 'ELHT01126', 'TXDALSTD', 'The Heart Group', 'David', 'L', 'Brown', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1194717348', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00849', 'ELHT00849', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Chad', 'E', 'Coleman', 'MD', 'Family Practice', '', '', NULL, 'O', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '9727231474', '9727239423', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '9727231474', '9727239423', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1194768358', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.4671, -96.9768, NULL, NULL),
('911947573', 'ELHT00850', 'ELHT00850', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Chad', 'E', 'Coleman', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1194768358', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00851', 'ELHT00851', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Jerry', '', 'Cannaday', 'DO', 'Family Practice', '', '', NULL, 'O', '1575 I-30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', '1575 I 30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194774646', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8297, -96.6193, NULL, NULL),
('752536818', 'ELHT00852', 'ELHT00852', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Jerry', '', 'Cannaday', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194774646', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01127', 'ELHT01127', 'TXDALSTD', 'The Heart Group', 'Ambarish', '', 'Gopal', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '4716 Alliance Blvd Pavilion II', 'Plano', 'Collin', 'TX', '75093', '4698006100', '4698006110', '4716 Alliance Blvd Pavilion II', 'Plano', 'Collin', 'TX', '75093', '4698006100', '4698006110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1205008026', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7926, NULL, NULL),
('752536818', 'ELHT01128', 'ELHT01128', 'TXDALSTD', 'The Heart Group', 'Ambarish', '', 'Gopal', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1205008026', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00853', 'ELHT00853', 'TXDALSTD', 'Baylor Family Medicine at Wylie', 'Tena', 'P', 'Patterson', 'MD', 'Family Practice', '', '', NULL, 'O', '600 Cooper Dr Ste 100', 'Wylie', 'Collin', 'TX', '75098', '9724427325', '9724428348', '600 Cooper Dr Ste 100', 'Wylie', 'Collin', 'TX', '75098', '9724427325', '9724428348', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1205885670', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0092, -96.5443, NULL, NULL),
('752536818', 'ELHT00854', 'ELHT00854', 'TXDALSTD', 'Baylor Family Medicine at Wylie', 'Tena', 'P', 'Patterson', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1205885670', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00409', 'ELHT00409', 'TXDALSTD', 'MedProvider', 'Alfredo', '', 'Garcia', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 330', 'Dallas', 'Dallas', 'TX', '75204', '2148285070', '2148285071', '3434 Swiss Ave Ste 330', 'Dallas', 'Dallas', 'TX', '75204', '2148285070', '2148285071', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1205934767', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7915, -96.7824, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('752536818', 'ELHT00855', 'ELHT00855', 'TXDALSTD', 'Colleyville Family Medicine', 'Tyronne', 'A', 'Bush', 'DO', 'Family Practice', '', '', NULL, 'O', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215009683', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8864, -97.1519, NULL, NULL),
('752536818', 'ELHT00856', 'ELHT00856', 'TXDALSTD', 'Colleyville Family Medicine', 'Tyronne', 'A', 'Bush', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215009683', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00857', 'ELHT00857', 'TXDALSTD', 'City Square Community Health Services', 'Shanna', 'S', 'Garza', 'MD', 'Family Practice', '', '', NULL, 'O', '2835 Grand Ave', 'Dallas', 'Dallas', 'TX', '75215', '2148238710', '2148213282', '2835 Grand Ave', 'Dallas', 'Dallas', 'TX', '75215', '2148238710', '2148213282', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215152525', 0, 'N', 0, '2013-05-01', NULL, NULL, 32.7723, -96.7708, NULL, NULL),
('752536818', 'ELHT00858', 'ELHT00858', 'TXDALSTD', 'City Square Community Health Services', 'Shanna', 'S', 'Garza', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1215152525', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00411', 'ELHT00411', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Ruth', '', 'Boe', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1215241724', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00412', 'ELHT00412', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Ruth', '', 'Boe', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1215241724', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00859', 'ELHT00859', 'TXDALSTD', '', 'Aaron', 'R', 'Aldape', 'DO', 'Family Practice', '', '', NULL, 'O', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1215259841', 0, 'N', 0, '2014-01-30', NULL, NULL, 32.941, -97.1405, NULL, NULL),
('752536818', 'ELHT00860', 'ELHT00860', 'TXDALSTD', '', 'Aaron', 'R', 'Aldape', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1215259841', 0, 'Y', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00413', 'ELHT00413', 'TXDALSTD', 'Baylor Health Center at Park Cities', 'Mitchell', 'L', 'Huebner', 'MD', 'Internal Medicine', '', '', NULL, 'O', '9101 N Central Expwy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', '9101 N Central Expy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1215938071', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00414', 'ELHT00414', 'TXDALSTD', 'Baylor Health Center at Park Cities', 'Mitchell', 'L', 'Huebner', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1215938071', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00861', 'ELHT00861', 'TXDALSTD', 'Health Texas Provider Network', 'Melinda', 'B', 'Balarbar', 'MD', 'Family Practice', '', '', NULL, 'O', '1110 Parker Sq', 'Flower Mound', 'Denton', 'TX', '75028', '9727241707', '9727241407', '1110 Parker Sq', 'Flower Mound', 'Denton', 'TX', '75028', '9727241707', '9727241407', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1215960109', 0, 'N', 0, '2013-06-07', NULL, NULL, 33.0394, -97.0537, NULL, NULL),
('752536818', 'ELHT00862', 'ELHT00862', 'TXDALSTD', 'Health Texas Provider Network', 'Melinda', 'B', 'Balarbar', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1215960109', 0, 'Y', 0, '2013-06-07', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00863', 'ELHT00863', 'TXDALSTD', 'Baylor Family Medicine at Frisco', 'Mark', 'G', 'Meehlhause', 'MD', 'Family Practice', '', '', NULL, 'O', '2840 Legacy Dr Ste 400', 'Frisco', 'Denton', 'TX', '75034', '9727123652', '2146183614', '2840 Legacy Dr Ste 400', 'Frisco', 'Denton', 'TX', '75034', '9727123652', '2146183614', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Frisco', NULL, NULL, NULL, 'HCFA|UB|', '1215968417', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.1028, -96.8415, NULL, NULL),
('752536818', 'ELHT00864', 'ELHT00864', 'TXDALSTD', 'Baylor Family Medicine at Frisco', 'Mark', 'G', 'Meehlhause', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Frisco', NULL, NULL, NULL, 'HCFA|UB|', '1215968417', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752722718', 'ELHT00865', 'ELHT00865', 'TXDALSTD', 'Baylor Family Medical Center at Riverside', 'Jamie', 'A', 'Nivens', 'DO', 'Family Practice', '', '', NULL, 'O', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', 'HTPN', 'TXHCPCHTPN', NULL, '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1215983572', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.797, -97.0554, NULL, NULL),
('752536818', 'ELHT00339', 'ELHT00339', 'TXDALSTD', 'LVAD Clinic', 'Bernard', 'V', 'Fischbach', 'MD', 'Nephrology', '', '', NULL, 'O', '8080 N Central Expwy Ste 600 LB 82', 'Dallas', 'Dallas', 'TX', '75206', '8663771650', '4694675905', '8080 N Central Expy Ste 600 LB 82', 'Dallas', 'Dallas', 'TX', '75206', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1225016819', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8607, -96.7699, NULL, NULL),
('752536818', 'ELHT00340', 'ELHT00340', 'TXDALSTD', 'LVAD Clinic', 'Bernard', 'V', 'Fischbach', 'MD', 'Nephrology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1225016819', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00127', 'ELHT00127', 'TXDALSTD', 'Cardiovascular Surgical Specialists of Irving', 'Michal', '', 'Savcenko', 'MD', 'Thoracic Surgery', '', '', NULL, 'O', '1110 Cottonwood Ln Ste 215', 'Irving', 'Dallas', 'TX', '75038', '9722594781', '4694177947', '1110 Cottonwood Ln Ste 215', 'Irving', 'Dallas', 'TX', '75038', '9722594781', '4694177947', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, '', NULL, 'HCFA|UB|', '1225026776', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8652, -96.9601, NULL, NULL),
('752536818', 'ELHT00128', 'ELHT00128', 'TXDALSTD', 'Cardiovascular Surgical Specialists of Irving', 'Michal', '', 'Savcenko', 'MD', 'Thoracic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, '', NULL, 'HCFA|UB|', '1225026776', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00295', 'ELHT00295', 'TXDALSTD', 'Texas Urogynecology Associates', 'Michael', 'E', 'Carley', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3600 Gaston Ave Ste 558', 'Dallas', 'Dallas', 'TX', '75246', '2148208700', '2148188707', '3600 Gaston Ave Ste 558', 'Dallas', 'Dallas', 'TX', '75246', '2148208700', '2148188707', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1225053622', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('911947573', 'ELHT00296', 'ELHT00296', 'TXDALSTD', 'Texas Urogynecology Associates', 'Michael', 'E', 'Carley', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208700', '2148188707', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208700', '2148188707', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1225053622', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00415', 'ELHT00415', 'TXDALSTD', 'MedProvider', 'Rainer', 'A', 'Khetan', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 205', 'Dallas', 'Dallas', 'TX', '75204', '2148285775', '2148285071', '3434 Swiss Ave Ste 205', 'Dallas', 'Dallas', 'TX', '75204', '2148285775', '2148285071', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1225059256', 0, 'N', 0, '2013-07-23', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT00417', 'ELHT00417', 'TXDALSTD', 'Colleyville Family Medicine', 'Lorrie', 'B', 'Hayes', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225066913', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8864, -97.1519, NULL, NULL),
('752536818', 'ELHT00418', 'ELHT00418', 'TXDALSTD', 'Colleyville Family Medicine', 'Lorrie', 'B', 'Hayes', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225066913', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00419', 'ELHT00419', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Waxahachie', 'Eddie', 'R', 'Joslin', 'MD', 'Internal Medicine', '', '', NULL, 'O', '505 N Hwy 77 Ste 200', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231686', '9729377731', '505 N Hwy 77 Ste 200', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231686', '9729377731', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1225072556', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.3965, -96.8453, NULL, NULL),
('911947573', 'ELHT00420', 'ELHT00420', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Waxahachie', 'Eddie', 'R', 'Joslin', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1225072556', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00867', 'ELHT00867', 'TXDALSTD', 'Baylor Family Medicine at Uptown', 'Jun', 'H', 'Kong', 'MD', 'Family Practice', '', '', NULL, 'O', '4161 McKinney Ave Ste 300', 'Dallas', 'Dallas', 'TX', '75204', '2142196655', '2142196660', '4161 McKinney Ave Ste 300', 'Dallas', 'Dallas', 'TX', '75204', '2142196655', '2142196660', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, '', NULL, 'HCFA|UB|', '1225092984', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8156, -96.7912, NULL, NULL),
('752536818', 'ELHT00868', 'ELHT00868', 'TXDALSTD', 'Baylor Family Medicine at Uptown', 'Jun', 'H', 'Kong', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, '', NULL, 'HCFA|UB|', '1225092984', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00011', 'ELHT00011', 'TXDALSTD', 'Critical Care and Pulmonary Consultants of Dallas', 'Jennifer', 'A', 'Johnson', 'MD', 'Critical Care', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 550', 'Dallas', 'Dallas', 'TX', '75246', '9724510219', '2148211193', '3600 Gaston Ave Wadley Tower Ste 550', 'Dallas', 'Dallas', 'TX', '75246', '9724510219', '2148211193', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225120926', 0, 'Y', 0, '2014-01-06', NULL, NULL, 32.791, -96.7798, NULL, NULL),
('752536818', 'ELHT00012', 'ELHT00012', 'TXDALSTD', 'Critical Care and Pulmonary Consultants of Dallas', 'Jennifer', 'A', 'Johnson', 'MD', 'Critical Care', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225120926', 0, 'N', 0, '2014-01-06', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00421', 'ELHT00421', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Jack', 'F', 'Melton', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1225143142', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00422', 'ELHT00422', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Jack', 'F', 'Melton', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1225143142', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00175', 'ELHT00175', 'TXDALSTD', 'Physiatric Medicine Associates', 'Amy', 'J', 'Wilson', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '909 N Washington Ave', 'Dallas', 'Dallas', 'TX', '75246', '2148209300', '9724808356', '909 N Washington Ave', 'Dallas', 'Dallas', 'TX', '75246', '2148209300', '9724808356', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1235148677', 0, 'N', 0, '2013-06-14', NULL, NULL, 32.7918, -96.7791, NULL, NULL),
('752536818', 'ELHT00176', 'ELHT00176', 'TXDALSTD', 'Physiatric Medicine Associates', 'Amy', 'J', 'Wilson', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1235148677', 0, 'N', 0, '2013-06-14', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00423', 'ELHT00423', 'TXDALSTD', 'MedProvider', 'Greta', 'Lee', 'Brodsky', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 105', 'Dallas', 'Dallas', 'TX', '75204', '2148280010', '2148280014', '3434 Swiss Ave Ste 105', 'Dallas', 'Dallas', 'TX', '75204', '2148280010', '2148280014', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', 'Baylor University Medical Center', NULL, NULL, 'HCFA|UB|', '1235149154', 0, 'N', 0, '2013-04-05', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT00869', 'ELHT00869', 'TXDALSTD', 'Baylor Family Medicine at Wylie', 'John', 'W', 'Mercer', 'MD', 'Family Practice', '', '', NULL, 'O', '600 Cooper Dr Ste 100', 'Wylie', 'Collin', 'TX', '75098', '9724427325', '9724428348', '600 Cooper Dr Ste 100', 'Wylie', 'Collin', 'TX', '75098', '9724427325', '9724428348', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1235196957', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0092, -96.5443, NULL, NULL),
('752536818', 'ELHT00870', 'ELHT00870', 'TXDALSTD', 'Baylor Family Medicine at Wylie', 'John', 'W', 'Mercer', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1235196957', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00313', 'ELHT00313', 'TXDALSTD', 'Neurology Hospitalist Group', 'Maria', 'V', 'Recio Restrepo', 'MD', 'Neurology', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 1155', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', '3600 Gaston Ave Wadley Ste 1155', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1245214766', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00314', 'ELHT00314', 'TXDALSTD', 'Neurology Hospitalist Group', 'Maria', 'V', 'Recio Restrepo', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1245214766', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00425', 'ELHT00425', 'TXDALSTD', 'Headache Medicine Specialists of North Texas', 'George', 'R', 'Nissan', 'DO', 'Internal Medicine', '', '', NULL, 'O', '9101 N Central Expwy Ste 400', 'Dallas', 'Dallas', 'TX', '75231', '2148209272', '2148209003', '9101 N Central Expy Ste 400', 'Dallas', 'Dallas', 'TX', '75231', '2148209272', '2148209003', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245222033', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00426', 'ELHT00426', 'TXDALSTD', 'Headache Medicine Specialists of North Texas', 'George', 'R', 'Nissan', 'DO', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245222033', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00297', 'ELHT00297', 'TXDALSTD', 'Park Lane OB-GYN Associates', 'Elizabeth', 'A', 'Stevenson Gargiulo', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'O', '9101 N Central Expwy Ste 250', 'Dallas', 'Dallas', 'TX', '75231', '2148262979', '2148289169', '9101 N Central Expy Ste 250', 'Dallas', 'Dallas', 'TX', '75231', '2148262979', '2148289169', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245280569', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00298', 'ELHT00298', 'TXDALSTD', 'Park Lane OB-GYN Associates', 'Elizabeth', 'A', 'Stevenson Gargiulo', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245280569', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00427', 'ELHT00427', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Sandy', 'H', 'Lee', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1245282813', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.8341, -96.9592, NULL, NULL),
('752536818', 'ELHT00428', 'ELHT00428', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Sandy', 'H', 'Lee', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1245282813', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00261', 'ELHT00261', 'TXDALSTD', 'Spine Surgery Center', 'Matthew', '', 'Berchuck', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3409 Worth St Ste 300', 'Dallas', 'Dallas', 'TX', '75246', '2148208350', '2148208355', '3409 Worth St Ste 300', 'Dallas', 'Dallas', 'TX', '75246', '2148208350', '2148208355', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Specialty Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245283803', 0, 'N', 0, '2013-12-09', NULL, NULL, 32.7886, -96.779, NULL, NULL),
('911947573', 'ELHT00262', 'ELHT00262', 'TXDALSTD', 'Spine Surgery Center', 'Matthew', '', 'Berchuck', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Specialty Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245283803', 0, 'N', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00871', 'ELHT00871', 'TXDALSTD', 'Baylor Family Medicine at Fort Worth', 'James', 'A', 'Murphy', 'MD', 'Family Practice', '', '', NULL, 'O', '900 W Magnolia Ave Ste 201', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179216166', '8179219594', '900 W Magnolia Ste 201', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179216166', '8179219594', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1245288398', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7306, -97.3342, NULL, NULL),
('752536818', 'ELHT00872', 'ELHT00872', 'TXDALSTD', 'Baylor Family Medicine at Fort Worth', 'James', 'A', 'Murphy', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1245288398', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01129', 'ELHT01129', 'TXDALSTD', 'The Heart Group', 'Jack', 'L', 'Schwade', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1245317742', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('752536818', 'ELHT01130', 'ELHT01130', 'TXDALSTD', 'The Heart Group', 'Jack', 'L', 'Schwade', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1245317742', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00873', 'ELHT00873', 'TXDALSTD', 'Baylor Family Medicine at Lake Ridge', 'Annu', 'P', 'Mehta', 'MD', 'Family Practice', '', '', NULL, 'O', '4927 Lake Ridge Pkwy Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75052', '9726419000', '9726419002', '4927 Lake Ridge Pkwy Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75052', '9726419000', '9726419002', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245321330', 0, 'N', 0, '2013-07-30', NULL, NULL, 32.6528, -97.0434, NULL, NULL),
('752536818', 'ELHT00874', 'ELHT00874', 'TXDALSTD', 'Baylor Family Medicine at Lake Ridge', 'Annu', 'P', 'Mehta', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245321330', 0, 'Y', 0, '2013-07-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00723', 'ELHT00723', 'TXDALSTD', 'Surgical and Bariatric Consultants of DFW', 'Chad', 'J', 'Carlton', 'MD', 'General Surgery', '', '', NULL, 'O', '1420 8th Ave Ste 101', 'Ft Worth', 'Tarrant', 'TX', '76104', '8172079775', '8179201786', '1420 8th Ave Ste 101', 'Ft Worth', 'Tarrant', 'TX', '76104', '8172079775', '8179201786', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-15', 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', '', 'HCFA|UB|', '1245561109', 0, 'N', 0, '2014-04-25', NULL, NULL, 32.7298, -97.3444, NULL, NULL),
('752536818', 'ELHT00724', 'ELHT00724', 'TXDALSTD', 'Surgical and Bariatric Consultants of DFW', 'Chad', 'J', 'Carlton', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-15', 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', '', 'HCFA|UB|', '1245561109', 0, 'Y', 0, '2014-04-25', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00263', 'ELHT00263', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'Christian', 'T', 'Royer', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3900 Junius St Ste 500', 'Dallas', 'Dallas', 'TX', '75246', '2148237090', '2148231644', '3900 Junius St Ste 500', 'Dallas', 'Dallas', 'TX', '75246', '2148237090', '2148231644', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-05-31', 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1255321634', 0, 'N', 0, '2013-07-31', NULL, NULL, 32.7913, -96.7775, NULL, NULL),
('752536818', 'ELHT00264', 'ELHT00264', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'Christian', 'T', 'Royer', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'PO Box 844128  ', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1255321634', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00013', 'ELHT00013', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Jason', 'P', 'Clark', 'MD', 'Critical Care', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255356150', 0, 'Y', 0, '2013-05-08', NULL, NULL, 32.79, -96.7806, NULL, NULL),
('911947573', 'ELHT00014', 'ELHT00014', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Jason', 'P', 'Clark', 'MD', 'Critical Care', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255356150', 0, 'N', 0, '2013-05-08', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00875', 'ELHT00875', 'TXDALSTD', 'Baylor Family Medicine at Highland Village', 'Trisha', 'E', 'Smith', 'MD', 'Family Practice', '', '', NULL, 'O', '2900 Village Pkwy Ste 300', 'Highland Village', 'Denton', 'TX', '75077', '4698000500', '4698000510', '2900 Village Pkwy Ste 300', 'Highland Village', 'Denton', 'TX', '75077', '4698000500', '4698000510', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255359360', 0, 'N', 0, '2013-04-26', NULL, NULL, 33.0789, -97.0789, NULL, NULL),
('752536818', 'ELHT00876', 'ELHT00876', 'TXDALSTD', 'Baylor Family Medicine at Highland Village', 'Trisha', 'E', 'Smith', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255359360', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00209', 'ELHT00209', 'TXDALSTD', 'Baylor Pediatric Center', 'Stefanie', 'D', 'Spaeth', 'MD', 'Pediatrics', '', '', NULL, 'O', '9101 N Central Expwy Ste 420', 'Dallas', 'Dallas', 'TX', '75231', '2148232525', '2148260466', '9101 N Central Expy Ste 420', 'Dallas', 'Dallas', 'TX', '75231', '2148232525', '2148260466', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255361473', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00210', 'ELHT00210', 'TXDALSTD', 'Baylor Pediatric Center', 'Stefanie', 'D', 'Spaeth', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255361473', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
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('752536818', 'ELHT00878', 'ELHT00878', 'TXDALSTD', 'Family Medical Center at North Garland', 'Clifford', 'T', 'Fullerton', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255361622', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00879', 'ELHT00879', 'TXDALSTD', 'Family Medical Center at Baylor', 'Dana', 'A', 'Bleakney', 'MD', 'Family Practice', '', '', NULL, 'O', '3600 Gaston Ave Barnett Tower Ste 1109', 'Dallas', 'Dallas', 'TX', '75246', '2148208300', '2148208313', '3600 Gaston Ave Barnett Ste 1109', 'Dallas', 'Dallas', 'TX', '75246', '2148208300', '2148208313', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255368502', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00880', 'ELHT00880', 'TXDALSTD', 'Family Medical Center at Baylor', 'Dana', 'A', 'Bleakney', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255368502', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00881', 'ELHT00881', 'TXDALSTD', 'Baylor Family Medicine at Fort Worth', 'David', 'C', 'Jordan', 'MD', 'Family Practice', '', '', NULL, 'O', '900 W Magnolia Ave Ste 201', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179216166', '8179219594', '900 W Magnolia Ste 201', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179216166', '8179219594', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1255377552', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7306, -97.3342, NULL, NULL),
('752536818', 'ELHT00882', 'ELHT00882', 'TXDALSTD', 'Baylor Family Medicine at Fort Worth', 'David', 'C', 'Jordan', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1255377552', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00883', 'ELHT00883', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'Lindsey', 'L', 'Foote', 'MD', 'Family Practice', '', '', NULL, 'O', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255389789', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8645, -96.4413, NULL, NULL),
('752536818', 'ELHT00884', 'ELHT00884', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'Lindsey', 'L', 'Foote', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255389789', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01191', 'ELHT01191', 'TXDALSTD', 'The Heart Group', 'Martin', 'S', 'Weiss', 'DO', 'Cardiovascular Disease', '', '', NULL, 'O', '5236 W University Dr Ste 4900', 'Mckinney', 'Collin', 'TX', '75071', '4698005350', '4698005386', '5236 W University Dr Ste 4900', 'Mckinney', 'Collin', 'TX', '75071', '4698005350', '4698005386', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, '', '', 'HCFA|UB|', '1255396263', 0, 'N', 0, '2013-12-09', NULL, NULL, 33.2183, -96.684, NULL, NULL),
('752536818', 'ELHT01192', 'ELHT01192', 'TXDALSTD', 'The Heart Group', 'Martin', 'S', 'Weiss', 'DO', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, '', '', 'HCFA|UB|', '1255396263', 0, 'Y', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00177', 'ELHT00177', 'TXDALSTD', 'Physiatric Medicine Associates', 'Susan', 'K', 'Warden', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '909 N Washington Ave', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', '909 N Washington', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1255480604', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7918, -96.7791, NULL, NULL),
('752536818', 'ELHT00178', 'ELHT00178', 'TXDALSTD', 'Physiatric Medicine Associates', 'Susan', 'K', 'Warden', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1255480604', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00429', 'ELHT00429', 'TXDALSTD', 'MedProvider', 'Christopher', 'A', 'Hughes', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 330', 'Dallas', 'Dallas', 'TX', '75204', '2148285000', '2148285071', '3434 Swiss Ave Ste 330', 'Dallas', 'Dallas', 'TX', '75204', '2148285000', '2148285071', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255491858', 0, 'N', 0, '2013-06-14', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT00885', 'ELHT00885', 'TXDALSTD', 'Family Medical Center at Garland', 'Nicole', 'S', 'Conselman', 'MD', 'Family Practice', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 140', 'Garland', 'Dallas', 'TX', '75042', '9722726561', '9722763067', '601 Clara Barton Blvd Ste 140', 'Garland', 'Dallas', 'TX', '75042', '9722726561', '9722763067', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1265450118', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00886', 'ELHT00886', 'TXDALSTD', 'Family Medical Center at Garland', 'Nicole', 'S', 'Conselman', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1265450118', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
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('752536818', 'ELHT00888', 'ELHT00888', 'TXDALSTD', 'Baylor Community Care at Worth Street', 'Erin', 'P', 'Kane', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1265455752', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01193', 'ELHT01193', 'TXDALSTD', 'Cardiovascular Consultants of North Texas', 'Trent', 'L', 'Pettijohn', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6300 W Parker Rd MOB II 125', 'Plano', 'Collin', 'TX', '75093', '4698004400', '4698004410', '6300 W Parker Rd MOB II 125', 'Plano', 'Collin', 'TX', '75093', '4698004400', '4698004410', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', '', 'HCFA|UB|', '1265468706', 0, 'N', 0, '2013-12-09', NULL, NULL, 33.0451, -96.8374, NULL, NULL),
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('752536818', 'ELHT00758', 'ELHT00758', 'TXDALSTD', 'Liver Consultants of Texas', 'Gary', 'L', 'Davis', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265479364', 0, 'Y', 0, '2013-09-16', NULL, NULL, 0, 0, NULL, NULL),
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('752536818', 'ELHT00889', 'ELHT00889', 'TXDALSTD', 'Baylor Family Medicine at Frisco', 'Stephanie', 'L', 'Cudjoe', 'MD', 'Family Practice', '', '', NULL, 'O', '2840 Legacy Dr Ste 400', 'Frisco', 'Denton', 'TX', '75034', '9727123652', '2146183614', '2840 Legacy Dr Ste 400', 'Frisco', 'Denton', 'TX', '75034', '9727123652', '2146183614', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Frisco', NULL, NULL, NULL, 'HCFA|UB|', '1265624571', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.1028, -96.8415, NULL, NULL),
('752536818', 'ELHT00890', 'ELHT00890', 'TXDALSTD', 'Baylor Family Medicine at Frisco', 'Stephanie', 'L', 'Cudjoe', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Frisco', NULL, NULL, NULL, 'HCFA|UB|', '1265624571', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('752536818', 'ELHT00891', 'ELHT00891', 'TXDALSTD', 'Baylor Community Care at Worth Street', 'Christopher', 'E', 'Berry', 'MD', 'Family Practice', '', '', NULL, 'O', '4001 Worth St', 'Dallas', 'Dallas', 'TX', '75246', '2148281745', '2148281734', '4001 Worth St', 'Dallas', 'Dallas', 'TX', '75246', '2148281745', '2148281734', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-02-28', 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275503641', 0, 'N', 0, '2014-02-19', NULL, NULL, 32.7916, -96.7759, NULL, NULL),
('752536818', 'ELHT00892', 'ELHT00892', 'TXDALSTD', 'Baylor Community Care at Worth Street', 'Christopher', 'E', 'Berry', 'MD', 'Family Practice', '', '', NULL, 'B', 'P O Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-02-28', 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275503641', 0, 'Y', 0, '2013-05-08', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00179', 'ELHT00179', 'TXDALSTD', 'Physiatric Medicine Associates', 'Rajashree', '', 'Srinivasan', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '3301 Swiss Ave', 'Dallas', 'Dallas', 'TX', '75204', '2148209812', '2148209878', '3301 Swiss Ave', 'Dallas', 'Dallas', 'TX', '75204', '2148209812', '2148209878', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1275541633', 0, 'N', 0, '2013-06-14', NULL, NULL, 32.7904, -96.7831, NULL, NULL),
('752536818', 'ELHT00180', 'ELHT00180', 'TXDALSTD', 'Physiatric Medicine Associates', 'Rajashree', '', 'Srinivasan', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1275541633', 0, 'N', 0, '2013-06-14', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00181', 'ELHT00181', 'TXDALSTD', 'Physiatric Medicine Associates', 'Helen', 'Z', 'Patel', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '909 N Washington Ave', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', '909 N Washington', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1275542755', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7918, -96.7791, NULL, NULL),
('752536818', 'ELHT00182', 'ELHT00182', 'TXDALSTD', 'Physiatric Medicine Associates', 'Helen', 'Z', 'Patel', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1275542755', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00211', 'ELHT00211', 'TXDALSTD', 'Pediatric and Adolescent Associates of Garland', 'Myron', 'H', 'Rosen', 'MD', 'Pediatrics', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 250', 'Garland', 'Dallas', 'TX', '75042', '9722727887', '9722727992', '601 Clara Barton Blvd Ste 250', 'Garland', 'Dallas', 'TX', '75042', '9722727887', '9722727992', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1275587156', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00212', 'ELHT00212', 'TXDALSTD', 'Pediatric and Adolescent Assoc of Garland', 'Myron', 'H', 'Rosen', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1275587156', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00433', 'ELHT00433', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Catherine', 'A', 'Raver', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave 4th floor', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275610586', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00434', 'ELHT00434', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Catherine', 'A', 'Raver', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275610586', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00435', 'ELHT00435', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Kyle', 'D', 'Molen', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1275648040', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00436', 'ELHT00436', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Kyle', 'D', 'Molen', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1275648040', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00437', 'ELHT00437', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Peter', 'S', 'Stack', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1275649725', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00438', 'ELHT00438', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Peter', 'S', 'Stack', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1275649725', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00213', 'ELHT00213', 'TXDALSTD', 'Colleyville Family Medicine', 'Elizabeth', 'A', 'Henderson', 'MD', 'Pediatrics', '', '', NULL, 'O', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275716664', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8864, -97.1519, NULL, NULL),
('752536818', 'ELHT00214', 'ELHT00214', 'TXDALSTD', 'Colleyville Family Medicine', 'Elizabeth', 'A', 'Henderson', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275716664', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00315', 'ELHT00315', 'TXDALSTD', 'Multiple Sclerosis Treatment Center of Dallas', 'Annette', 'F', 'Okai', 'MD', 'Neurology', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 1155', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', '3600 Gaston Ave Wadley Tower Ste 1155', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2014-03-31', 0, 0, 0, 'Baylor University Medical Center', '', '', '', 'HCFA|UB|', '1275755399', 0, 'N', 0, '2014-04-17', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00316', 'ELHT00316', 'TXDALSTD', 'Multiple Sclerosis Treatment Center of Dallas', 'Annette', 'F', 'Okai', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2014-03-31', 0, 0, 0, 'Baylor University Medical Center', '', '', '', 'HCFA|UB|', '1275755399', 0, 'N', 0, '2014-04-17', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00439', 'ELHT00439', 'TXDALSTD', 'Plano IPCU', 'Carl', 'E', 'Ciborowski', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1285657536', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0144, -96.7924, NULL, NULL),
('752582845', 'ELHT00440', 'ELHT00440', 'TXDALSTD', 'Plano IPCU', 'Carl', 'E', 'Ciborowski', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1285657536', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00893', 'ELHT00893', 'TXDALSTD', 'Baylor Family Medicine at Flower Mound', 'Joseph', 'P', 'Santiago', 'MD', 'Family Practice', '', '', NULL, 'O', '1110 Parker Sq', 'Flower Mound', 'Denton', 'TX', '75028', '9727241707', '9727241407', '1110 Parker Sq', 'Flower Mound', 'Denton', 'TX', '75028', '9727241707', '9727241407', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1285667188', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0394, -97.0537, NULL, NULL),
('752536818', 'ELHT00894', 'ELHT00894', 'TXDALSTD', 'Baylor Family Medicine at Flower Mound', 'Joseph', 'P', 'Santiago', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1285667188', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00183', 'ELHT00183', 'TXDALSTD', 'Physiatric Medicine Associates', 'Rodney', 'R', 'Thorley', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '800 N Shiloh Rd', 'Garland', 'Dallas', 'TX', '75042', '9724875574', '9724875139', '800 N Shiloh Rd', 'Garland', 'Dallas', 'TX', '75042', '9724875574', '9724875139', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2012-10-01', 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1285695817', 0, 'N', 0, '2013-07-31', NULL, NULL, 32.9198, -96.6648, NULL, NULL),
('752536818', 'ELHT00184', 'ELHT00184', 'TXDALSTD', 'Physiatric Medicine Associates', 'Rodney', 'R', 'Thorley', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1285695817', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00317', 'ELHT00317', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Alberto', 'M', 'Santos', 'MD', 'Neurology', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1285894600', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00318', 'ELHT00318', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Alberto', 'M', 'Santos', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1285894600', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00155', 'ELHT00155', 'TXDALSTD', 'Dallas Diagnostic Association Garland', 'Kasturi', '', 'Inaganti', 'MD', 'Rheumatology', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 300', 'Garland', 'Dallas', 'TX', '75042', '4698002000', '9722722073', '601 Clara Barton Blvd Ste 300', 'Garland', 'Dallas', 'TX', '75042', '4698002000', '9722722073', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1295764181', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00156', 'ELHT00156', 'TXDALSTD', 'Dallas Diagnostic Association Garland', 'Kasturi', '', 'Inaganti', 'MD', 'Rheumatology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1295764181', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00215', 'ELHT00215', 'TXDALSTD', 'Baylor Pediatric Center', 'Marjorie', 'R', 'Milici', 'MD', 'Pediatrics', '', '', NULL, 'O', '9101 N Central Expwy Ste 420', 'Dallas', 'Dallas', 'TX', '75231', '2148232525', '2148260466', '9101 N Central Expy Ste 420', 'Dallas', 'Dallas', 'TX', '75231', '2148232525', '2148260466', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295765410', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00216', 'ELHT00216', 'TXDALSTD', 'Baylor Pediatric Center', 'Marjorie', 'R', 'Milici', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295765410', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01195', 'ELHT01195', 'TXDALSTD', 'Legacy Heart Group', 'Srinivasa', 'P', 'Potluri', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1295783736', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0625, -96.7963, NULL, NULL),
('752536818', 'ELHT01196', 'ELHT01196', 'TXDALSTD', 'Legacy Heart Group', 'Srinivasa', 'P', 'Potluri', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1295783736', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00759', 'ELHT00759', 'TXDALSTD', 'Texas Digestive Health Consultants', 'James', 'S', 'Burdick', 'MD', 'Gastroenterology', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 556', 'Dallas', 'Dallas', 'TX', '75246', '2148208899', '2148208868', '3600 Gaston Ave Ste 556 Wadley', 'Dallas', 'Dallas', 'TX', '75246', '2148208899', '2148208868', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295791564', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00760', 'ELHT00760', 'TXDALSTD', 'Texas Digestive Health Consultants', 'James', 'S', 'Burdick', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295791564', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00319', 'ELHT00319', 'TXDALSTD', 'Neurovascular Associates of Texas', 'Dion', 'F', 'Graybeal', 'MD', 'Neurology', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 1155', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', '3600 Gaston Ave Wadley Ste 1155 ', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1295796589', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00321', 'ELHT00321', 'TXDALSTD', 'Neurovascular Associates of Texas', 'Dion', 'F', 'Graybeal', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1295796589', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00895', 'ELHT00895', 'TXDALSTD', 'Family Medical Center at North Garland', 'Andrea', 'M', 'McKnight', 'MD', 'Family Practice', '', '', NULL, 'O', '5345 N George Bush Fwy', 'Garland', 'Dallas', 'TX', '75040', '9724955888', '9724950588', '5345 N George Bush Fwy', 'Garland', 'Dallas', 'TX', '75040', '9724955888', '9724950588', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295961456', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9651, -96.6418, NULL, NULL),
('752536818', 'ELHT00896', 'ELHT00896', 'TXDALSTD', 'Family Medical Center at North Garland', 'Andrea', 'M', 'McKnight', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295961456', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00441', 'ELHT00441', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Seema', 'S', 'Bhat', 'DO', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave 4th floor', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1306008537', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00442', 'ELHT00442', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Seema', 'S', 'Bhat', 'DO', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1306008537', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01197', 'ELHT01197', 'TXDALSTD', 'Cardiovascular Consultants of North Texas', 'Sabrina', '', 'Stone', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '4708 Alliance Blvd Ste 720', 'Plano', 'Collin', 'TX', '75093', '4698004400', '4698004410', '4708 Alliance Blvd Ste 720', 'Plano', 'Collin', 'TX', '75093', '4698004400', '4698004410', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', '', 'HCFA|UB|', '1306104161', 0, 'N', 0, '2013-12-09', NULL, NULL, 33.0138, -96.7917, NULL, NULL),
('752536818', 'ELHT01198', 'ELHT01198', 'TXDALSTD', 'Cardiovascular Consultants of North Texas', 'Sabrina', '', 'Stone', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', '', 'HCFA|UB|', '1306104161', 0, 'Y', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('751837454', 'ELHT00703', 'ELHT00703', 'TXDALSTD', 'Health Texas Provider Network', 'Joyce', 'M', 'Thompson', 'MD', 'Geriatrics', '', '', NULL, 'O', '4004 Worth St Ste 100', 'Dallas', 'Dallas', 'TX', '75246', '2148206060', '2148206361', '4004 Worth St Ste 100', 'Dallas', 'Dallas', 'TX', '75246', '2148206060', '2148206361', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', '', '', '', 'HCFA|UB|', '1306861448', 0, 'Y', 0, '2014-04-17', NULL, NULL, 32.7913, -96.7758, NULL, NULL),
('751837454', 'ELHT00704', 'ELHT00704', 'TXDALSTD', 'Health Texas Provider Network', 'Joyce', 'M', 'Thompson', 'MD', 'Geriatrics', '', '', NULL, 'B', 'PO Box 844013', 'Dallas', 'Dallas', 'TX', '75284', '2148209480', '2148208995', 'PO Box 844013', 'Dallas', 'Dallas', 'TX', '75284', '2148209480', '2148208995', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', '', '', '', 'HCFA|UB|', '1306861448', 0, 'Y', 0, '2014-04-17', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00443', 'ELHT00443', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Musa', 'G', 'Varwani', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1306890835', 0, 'Y', 0, '2013-05-01', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00444', 'ELHT00444', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Musa', 'G', 'Varwani', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1306890835', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00445', 'ELHT00445', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Carl', 'T', 'Long', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1306951215', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00446', 'ELHT00446', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Carl', 'T', 'Long', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1306951215', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00447', 'ELHT00447', 'TXDALSTD', 'MedProvider', 'William', 'T', 'Christensen', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 206', 'Dallas', 'Dallas', 'TX', '75204', '2148285660', '2148285659', '3434 Swiss Ave Ste 206', 'Dallas', 'Dallas', 'TX', '75204', '2148285660', '2148285659', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', 'Baylor Specialty Hospital', NULL, NULL, 'HCFA|UB|', '1316020332', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT01131', 'ELHT01131', 'TXDALSTD', 'Cardiology Consultants of Texas', 'Haojie', '', 'Wang', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '621 N Hall St Ste 400', 'Dallas', 'Dallas', 'TX', '75226', '2148248721', '2142376529', '621 N Hall St Ste 400', 'Dallas', 'Dallas', 'TX', '75226', '2148248721', '2142376529', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor University Medical Center', NULL, NULL, 'HCFA|UB|', '1316107246', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7879, -96.7802, NULL, NULL),
('752536818', 'ELHT01132', 'ELHT01132', 'TXDALSTD', 'Cardiology Consultants of Texas', 'Haojie', '', 'Wang', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor University Medical Center', NULL, NULL, 'HCFA|UB|', '1316107246', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00897', 'ELHT00897', 'TXDALSTD', 'Baylor Family Medicine at Flower Mound', 'Kathryn', 'M', 'Simon', 'MD', 'Family Practice', '', '', NULL, 'O', '1110 Parker Sq', 'Flower Mound', 'Denton', 'TX', '75028', '9727241707', '9727241407', '1110 Parker Sq', 'Flower Mound', 'Denton', 'TX', '75028', '9727241707', '9727241407', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1316962038', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0394, -97.0537, NULL, NULL),
('752536818', 'ELHT00898', 'ELHT00898', 'TXDALSTD', 'Baylor Family Medicine at Flower Mound', 'Kathryn', 'M', 'Simon', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1316962038', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00761', 'ELHT00761', 'TXDALSTD', 'Liver Consultants of Texas', 'Robert', 'P', 'Perrillo', 'MD', 'Gastroenterology', '', '', NULL, 'O', '3410 Worth St Ste 860', 'Dallas', 'Dallas', 'TX', '75246', '2148208500', '2148208168', '3410 Worth St Ste 860', 'Dallas', 'Dallas', 'TX', '75246', '2148208500', '2148208168', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316962327', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7886, -96.779, NULL, NULL),
('752536818', 'ELHT00762', 'ELHT00762', 'TXDALSTD', 'Liver Consultants of Texas', 'Robert', 'P', 'Perrillo', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1316962327', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00265', 'ELHT00265', 'TXDALSTD', 'Sports Physicians Orthopaedic and Rehabilitation of Texas', 'Robert', 'E', 'Berry', 'DO', 'Orthopedic Surgery', '', '', NULL, 'O', '4716 Alliance Blvd Ste 600', 'Plano', 'Collin', 'TX', '75093', '8774477678', '9728603265', '4716 Alliance Blvd Ste 600', 'Plano', 'Collin', 'TX', '75093', '8774477678', '9728603265', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1316971740', 0, 'N', 0, '2013-12-09', NULL, NULL, 33.0145, -96.7926, NULL, NULL),
('752536818', 'ELHT00266', 'ELHT00266', 'TXDALSTD', 'Sports Physicians Orthopaedic and Rehabilitation of Texas', 'Robert', 'E', 'Berry', 'DO', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1316971740', 0, 'N', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00449', 'ELHT00449', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'James', 'E', 'Sutton', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1316992498', 0, 'Y', 0, '2013-05-01', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00450', 'ELHT00450', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'James', 'E', 'Sutton', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1316992498', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01133', 'ELHT01133', 'TXDALSTD', 'The Heart Group', 'Ronald', 'H', 'Underwood', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1326030982', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('752536818', 'ELHT01134', 'ELHT01134', 'TXDALSTD', 'The Heart Group', 'Ronald', 'H', 'Underwood', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1326030982', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01199', 'ELHT01199', 'TXDALSTD', 'Legacy Heart Group', 'Philip', 'A', 'Morales', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1326035643', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0625, -96.7963, NULL, NULL),
('752536818', 'ELHT01200', 'ELHT01200', 'TXDALSTD', 'Legacy Heart Group', 'Philip', 'A', 'Morales', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1326035643', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00039', 'ELHT00039', 'TXDALSTD', 'North Texas Health Care Associates Endocrinology', 'Joseph', 'L', 'Milburn', 'MD', 'Endocrinology', '', '', NULL, 'O', '2021 N MacArthur Blvd Ste 515', 'Irving', 'Dallas', 'TX', '75061', '9722593282', '9722592033', '2021 N MacArthur Blvd Ste 515', 'Irving', 'Dallas', 'TX', '75061', '9722593282', '9722592033', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1326066457', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.835, -96.9592, NULL, NULL),
('752536818', 'ELHT00040', 'ELHT00040', 'TXDALSTD', 'North Texas Health Care Associates Endocrinology', 'Joseph', 'L', 'Milburn', 'MD', 'Endocrinology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1326066457', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01135', 'ELHT01135', 'TXDALSTD', 'Legacy Heart Group', 'Marc', 'S', 'Shalek', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', '6601 Preston Rd', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1336136878', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0625, -96.7963, NULL, NULL),
('752536818', 'ELHT01136', 'ELHT01136', 'TXDALSTD', 'Legacy Heart Group', 'Marc', 'S', 'Shalek', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1336136878', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911982510', 'ELHT00899', 'ELHT00899', 'TXDALSTD', 'Health Texas Provider Network', 'Tyson', 'H', 'Barnes', 'MD', 'Family Practice', '', '', NULL, 'O', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336169655', 0, 'N', 0, '2013-06-07', NULL, NULL, 32.7372, -96.2749, NULL, NULL),
('911982510', 'ELHT00900', 'ELHT00900', 'TXDALSTD', 'Health Texas Provider Network', 'Tyson', 'H', 'Barnes', 'MD', 'Family Practice', '', '', NULL, 'B', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336169655', 0, 'Y', 0, '2013-06-07', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00901', 'ELHT00901', 'TXDALSTD', 'Baylor Family Medicine at Frisco', 'Valerie', 'K', 'Kasmiersky', 'MD', 'Family Practice', '', '', NULL, 'O', '2840 Legacy Dr Ste 400', 'Frisco', 'Denton', 'TX', '75034', '9727123652', '2146183614', '2840 Legacy Dr Ste 400', 'Frisco', 'Denton', 'TX', '75034', '9727123652', '2146183614', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Frisco', NULL, NULL, NULL, 'HCFA|UB|', '1336177088', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.1028, -96.8415, NULL, NULL),
('752536818', 'ELHT00902', 'ELHT00902', 'TXDALSTD', 'Baylor Family Medicine at Frisco', 'Valerie', 'K', 'Kasmiersky', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Frisco', NULL, NULL, NULL, 'HCFA|UB|', '1336177088', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00451', 'ELHT00451', 'TXDALSTD', '', 'Eidi', '', 'Millington', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1336340694', 0, 'N', 0, '2014-01-24', NULL, NULL, 32.3968, -96.865, NULL, NULL),
('911947573', 'ELHT00452', 'ELHT00452', 'TXDALSTD', '', 'Eidi', '', 'Millington', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1336340694', 0, 'N', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00185', 'ELHT00185', 'TXDALSTD', 'Physiatric Medicine Associates', 'Stephen', 'W', 'Thomason', 'DO', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '909 N Washington Ave', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', '909 N Washington', 'Dallas', 'Dallas', 'TX', '75246', '2148209593', '9724808356', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1336382084', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7918, -96.7791, NULL, NULL),
('752536818', 'ELHT00186', 'ELHT00186', 'TXDALSTD', 'Physiatric Medicine Associates', 'Stephen', 'W', 'Thomason', 'DO', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1336382084', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00903', 'ELHT00903', 'TXDALSTD', 'Baylor Family Medicine at Ennis', 'Jesus', '', 'Trejo', 'MD', 'Family Practice', '', '', NULL, 'O', '1905 W Ennis Ave Ste 506', 'Ennis', 'Ellis', 'TX', '75119', '8555039900', '8555039910', '1905 W Ennis Ave Ste 506', 'Ennis', 'Ellis', 'TX', '75119', '8555039900', '8555039910', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', '', 'HCFA|UB|', '1336434125', 0, 'N', 0, '2013-12-09', NULL, NULL, 32.3192, -96.6469, NULL, NULL),
('752536818', 'ELHT00904', 'ELHT00904', 'TXDALSTD', 'Baylor Family Medicine at Ennis', 'Jesus', '', 'Trejo', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', '', 'HCFA|UB|', '1336434125', 0, 'Y', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00267', 'ELHT00267', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'Phillip', 'E', 'Hansen', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3900 Junius St Ste 500', 'Dallas', 'Dallas', 'TX', '75246', '2148237090', '2148231644', '3900 Junius St Ste 500', 'Dallas', 'Dallas', 'TX', '75246', '2148237090', '2148231644', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-05-31', 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1346230810', 0, 'N', 0, '2013-07-31', NULL, NULL, 32.7913, -96.7775, NULL, NULL),
('752536818', 'ELHT00268', 'ELHT00268', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'Phillip', 'E', 'Hansen', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'PO Box 844128  ', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1346230810', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00299', 'ELHT00299', 'TXDALSTD', 'Texas Urogynecology Associates', 'Muriel', 'K', 'Boreham', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3600 Gaston Ave Ste 558', 'Dallas', 'Dallas', 'TX', '75246', '2148208700', '2148188707', '3600 Gaston Ave Ste 558', 'Dallas', 'Dallas', 'TX', '75246', '2148208700', '2148188707', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1346273034', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('911947573', 'ELHT00300', 'ELHT00300', 'TXDALSTD', 'Texas Urogynecology Associates', 'Muriel', 'K', 'Boreham', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208700', '2148188707', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208700', '2148188707', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1346273034', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01201', 'ELHT01201', 'TXDALSTD', 'Grapevine Cardiology', 'Kevin', 'P', 'Theleman', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1643 Lancaster Dr Ste 203', 'Grapevine', 'Tarrant', 'TX', '76051', '8173297670', '8174160145', '1643 Lancaster Dr Ste 203', 'Grapevine', 'Tarrant', 'TX', '76051', '8173297670', '8174160145', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1346283439', 0, 'N', 0, '2013-12-09', NULL, NULL, 32.9321, -97.0939, NULL, NULL),
('752536818', 'ELHT01202', 'ELHT01202', 'TXDALSTD', 'Grapevine Cardiology', 'Kevin', 'P', 'Theleman', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1346283439', 0, 'Y', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00453', 'ELHT00453', 'TXDALSTD', 'Plano IPCU', 'Tiffany', 'M', 'Gillam', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1346405636', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0144, -96.7924, NULL, NULL),
('752582845', 'ELHT00454', 'ELHT00454', 'TXDALSTD', 'Plano IPCU', 'Tiffany', 'M', 'Gillam', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1346405636', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00725', 'ELHT00725', 'TXDALSTD', 'Baylor Community Care at Worth Street', 'Elizabeth', 'Z', 'Naftalis', 'MD', 'General Surgery', '', '', NULL, 'O', '4001 Worth St', 'Dallas', 'Dallas', 'TX', '75246', '2148281745', '2148281734', '4001 Worth St', 'Dallas', 'Dallas', 'TX', '75246', '2148281745', '2148281734', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1346536224', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7912, -96.7759, NULL, NULL),
('752536818', 'ELHT00726', 'ELHT00726', 'TXDALSTD', 'Baylor Community Care at Worth Street', 'Elizabeth', 'Z', 'Naftalis', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1346536224', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('752536818', 'ELHT00455', 'ELHT00455', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Ellen', 'S', 'Walraven', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356398457', 0, 'Y', 0, '2013-09-16', NULL, NULL, 32.8352, -96.961, NULL, NULL),
('752536818', 'ELHT00456', 'ELHT00456', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Ellen', 'S', 'Walraven', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356398457', 0, 'Y', 0, '2013-09-16', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00457', 'ELHT00457', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Amy', 'M', 'Gates', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave 4th floor', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356444707', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00458', 'ELHT00458', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Amy', 'M', 'Gates', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356444707', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00459', 'ELHT00459', 'TXDALSTD', 'Plano IPCU', 'Shahryar', 'S', 'Nassi', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1356542617', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0144, -96.7924, NULL, NULL),
('752582845', 'ELHT00460', 'ELHT00460', 'TXDALSTD', 'Plano IPCU', 'Shahryar', 'S', 'Nassi', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1356542617', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00015', 'ELHT00015', 'TXDALSTD', 'Critical Care and Pulmonary Consultants of Dallas', 'Anthony', 'L', 'Ortegon', 'MD', 'Critical Care', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 550', 'Dallas', 'Dallas', 'TX', '75246', '9724510219', '2148211193', '3600 Gaston Ave Wadley Ste 550', 'Dallas', 'Dallas', 'TX', '75246', '9724510219', '2148211193', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356550354', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00016', 'ELHT00016', 'TXDALSTD', 'Critical Care and Pulmonary Consultants of Dallas', 'Anthony', 'L', 'Ortegon', 'MD', 'Critical Care', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356550354', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00905', 'ELHT00905', 'TXDALSTD', 'Family Medical Center at Baylor', 'Rachael', 'C', 'Evans', 'DO', 'Family Practice', '', '', NULL, 'O', '3600 Gaston Ave Barnett Tower Ste 1109', 'Dallas', 'Dallas', 'TX', '75246', '2148208300', '2148208313', '3600 Gaston Ave Barnett Ste 1109', 'Dallas', 'Dallas', 'TX', '75246', '2148208300', '2148208313', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356556195', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00906', 'ELHT00906', 'TXDALSTD', 'Family Medical Center at Baylor', 'Rachael', 'C', 'Evans', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1356556195', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00907', 'ELHT00907', 'TXDALSTD', 'Baylor Family Medicine Southwest', 'Clark', 'A', 'Meador', 'DO', 'Family Practice', '', '', NULL, 'O', '5701 Bryant Irvin Rd Ste 301', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173616200', '8173616201', '5701 Bryant Irvin Rd Ste 301', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173616200', '8173616201', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', NULL, 'HCFA|UB|', '1356570865', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.6664, -97.4199, NULL, NULL),
('752536818', 'ELHT00908', 'ELHT00908', 'TXDALSTD', 'Baylor Family Medicine Southwest', 'Clark', 'A', 'Meador', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', NULL, 'HCFA|UB|', '1356570865', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01137', 'ELHT01137', 'TXDALSTD', 'LVAD Clinic', 'Johannes', 'J', 'Kuiper', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '8080 N Central Expwy Ste 600 LB 82', 'Dallas', 'Dallas', 'TX', '75206', '8663771650', '4694675905', '8080 N Central Expwy Ste 600 LB 82', 'Dallas', 'Dallas', 'TX', '75206', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366406043', 0, 'N', 0, '2013-11-04', NULL, NULL, 32.8607, -96.7699, NULL, NULL),
('752536818', 'ELHT01138', 'ELHT01138', 'TXDALSTD', 'LVAD Clinic', 'Johannes', 'J', 'Kuiper', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366406043', 0, 'Y', 0, '2013-11-04', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00909', 'ELHT00909', 'TXDALSTD', 'North Texas Health Care Associates Family Medicine', 'James', 'F', 'Havemann', 'MD', 'Family Practice', '', '', NULL, 'O', '400 W IH 635 Ste 210', 'Irving', 'Dallas', 'TX', '75063', '9728692772', '9728691747', '400 W IH 635 Ste 210', 'Irving', 'Dallas', 'TX', '75063', '9728692772', '9728691747', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1366460479', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9125, -96.9492, NULL, NULL),
('752536818', 'ELHT00910', 'ELHT00910', 'TXDALSTD', 'North Texas Health Care Associates Family Medicine', 'James', 'F', 'Havemann', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1366460479', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00911', 'ELHT00911', 'TXDALSTD', 'Baylor Family Medicine at Weatherford', 'Allen', 'B', 'Hornell', 'MD', 'Family Practice', '', '', NULL, 'O', '2035 Fort Worth Hwy Ste 100', 'Weatherford', 'Parker', 'TX', '76086', '8175940496', '8175996533', '2035 Fort Worth Hwy Ste 100', 'Weatherford', 'Parker', 'TX', '76086', '8175940496', '8175996533', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1366470247', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.757, -97.7443, NULL, NULL),
('752536818', 'ELHT00912', 'ELHT00912', 'TXDALSTD', 'Baylor Family Medicine at Weatherford', 'Allen', 'B', 'Hornell', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Carrollton', NULL, NULL, NULL, 'HCFA|UB|', '1366470247', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01105', 'ELHT01105', 'TXDALSTD', 'Dallas Diagnostic Association Garland', 'Daniel', 'A', 'Smith', 'MD', 'Dermatology', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 300', 'Garland', 'Dallas', 'TX', '75042', '4698002000', '9722722073', '601 Clara Barton Blvd Ste 300', 'Garland', 'Dallas', 'TX', '75042', '4698002000', '9722722073', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1366474454', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT01106', 'ELHT01106', 'TXDALSTD', 'Dallas Diagnostic Association Garland', 'Daniel', 'A', 'Smith', 'MD', 'Dermatology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1366474454', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00217', 'ELHT00217', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Kimberly', 'K', 'Sweet', 'MD', 'Pediatrics', '', '', NULL, 'O', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '8553050167', '9727239423', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '8553050167', '9727239423', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1366487159', 0, 'N', 0, '2014-03-19', NULL, NULL, 32.4671, -96.9768, NULL, NULL),
('911947573', 'ELHT00218', 'ELHT00218', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Kimberly', 'K', 'Sweet', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1366487159', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00763', 'ELHT00763', 'TXDALSTD', 'Health Texas Provider Network', 'Katrina', 'M', 'Bassel', 'MD', 'Gastroenterology', '', '', NULL, 'O', '4708 Alliance Blvd Ste 200', 'Plano', 'Collin', 'TX', '75093', '4698006020', '4698006001', '4708 Alliance Blvd Ste 200', 'Plano', 'Collin', 'TX', '75093', '4698006020', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1366555385', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00764', 'ELHT00764', 'TXDALSTD', 'Health Texas Provider Network', 'Katrina', 'M', 'Bassel', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1366555385', 0, 'Y', 0, '2014-01-08', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00765', 'ELHT00765', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Rassa', '', 'Shahidzadeh', 'MD', 'Gastroenterology', '', '', NULL, 'O', '4708 Alliance Blvd Ste 200', 'Plano', 'Collin', 'TX', '75093', '4698006020', '4698006001', '4708 Alliance Blvd Ste 200', 'Plano', 'Collin', 'TX', '75093', '4698006020', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1366563959', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00766', 'ELHT00766', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Rassa', '', 'Shahidzadeh', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1366563959', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00461', 'ELHT00461', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Kirtana', '', 'Sunderajan', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave 4th floor', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1366601049', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00462', 'ELHT00462', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Kirtana', '', 'Sunderajan', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1366601049', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00463', 'ELHT00463', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Erin', 'A', 'Reese', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-02-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366615643', 0, 'N', 0, '2013-05-08', NULL, NULL, 32.79, -96.7806, NULL, NULL),
('911947573', 'ELHT00464', 'ELHT00464', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Erin', 'A', 'Reese', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-02-22', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366615643', 0, 'N', 0, '2013-05-08', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00465', 'ELHT00465', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Christina', 'J', 'Kuo', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1366650772', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00466', 'ELHT00466', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Christina', 'J', 'Kuo', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1366650772', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00467', 'ELHT00467', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Imad', '', 'Salahuddin', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave 4th floor', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1366704926', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00468', 'ELHT00468', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Imad', '', 'Salahuddin', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1366704926', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00219', 'ELHT00219', 'TXDALSTD', 'Southlake Family Medicine', 'Arthur', 'E', 'Benzick', 'MD', 'Pediatrics', '', '', NULL, 'O', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1376500843', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.941, -97.1405, NULL, NULL),
('752536818', 'ELHT00220', 'ELHT00220', 'TXDALSTD', 'Southlake Family Medicine', 'Arthur', 'E', 'Benzick', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1376500843', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00913', 'ELHT00913', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Karen', 'P', 'Yeh', 'MD', 'Family Practice', '', '', NULL, 'O', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '9727231474', '9727239423', '1441 S Midlothian Pkwy Ste 100', 'Midlothian', 'Ellis', 'TX', '76065', '9727231474', '9727239423', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1376501924', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.4671, -96.9768, NULL, NULL),
('911947573', 'ELHT00914', 'ELHT00914', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Midlothian', 'Karen', 'P', 'Yeh', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1376501924', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00727', 'ELHT00727', 'TXDALSTD', 'Texas Surgical Specialists', 'Andre', 'D', 'Graham', 'MD', 'General Surgery', '', '', NULL, 'O', '1305 W Jefferson Ste 120', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231457', '9729231304', '1305 W Jefferson Ste 120', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231457', '9729231304', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', 'Baylor Medical Center at Waxahachie', NULL, NULL, 'HCFA|UB|', '1376525253', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.3961, -96.8638, NULL, NULL),
('911947573', 'ELHT00728', 'ELHT00728', 'TXDALSTD', 'Texas Surgical Specialists', 'Andre', 'D', 'Graham', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', 'Baylor Medical Center at Waxahachie', NULL, NULL, 'HCFA|UB|', '1376525253', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00129', 'ELHT00129', 'TXDALSTD', 'Cardiac Surgery Specialists', 'Michael', 'J', 'Mack', 'MD', 'Thoracic Surgery', '', '', NULL, 'O', '4716 Alliance Blvd Ste 310', 'Plano', 'Collin', 'TX', '75093', '4698006200', '4698006210', '4716 Alliance Blvd Ste 310', 'Plano', 'Collin', 'TX', '75093', '4698006200', '4698006210', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1376531913', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7926, NULL, NULL),
('752536818', 'ELHT00130', 'ELHT00130', 'TXDALSTD', 'Cardiac Surgery Specialists', 'Michael', 'J', 'Mack', 'MD', 'Thoracic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1376531913', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00729', 'ELHT00729', 'TXDALSTD', 'Texas Surgical Specialists', 'Valerie', 'J', 'Gorman', 'MD', 'General Surgery', '', '', NULL, 'O', '1305 W Jefferson Ste 120', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231457', '9729231304', '1305 W Jefferson Ste 120', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231457', '9729231304', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', 'Baylor Medical Center at Waxahachie', NULL, NULL, 'HCFA|UB|', '1376576017', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.3961, -96.8638, NULL, NULL),
('911947573', 'ELHT00730', 'ELHT00730', 'TXDALSTD', 'Texas Surgical Specialists', 'Valerie', 'J', 'Gorman', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', 'Baylor Medical Center at Waxahachie', NULL, NULL, 'HCFA|UB|', '1376576017', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00221', 'ELHT00221', 'TXDALSTD', '', 'Shawn', 'M', 'Abel', 'MD', 'Pediatrics', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 250', 'Garland', 'Dallas', 'TX', '75042', '9722727887', '9722727992', '601 Clara Barton Blvd Ste 250', 'Garland', 'Dallas', 'TX', '75042', '9722727887', '9722727992', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1376592550', 0, 'N', 0, '2014-01-30', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00222', 'ELHT00222', 'TXDALSTD', '', 'Shawn', 'M', 'Abel', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1376592550', 0, 'N', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00017', 'ELHT00017', 'TXDALSTD', 'Critical Care and Pulmonary Consultants of Dallas', 'Adan', '', 'Mora', 'MD', 'Critical Care', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 550', 'Dallas', 'Dallas', 'TX', '75246', '9724510219', '2148211193', '3600 Gaston Ave Wadley Ste 550', 'Dallas', 'Dallas', 'TX', '75246', '9724510219', '2148211193', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1376730549', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00018', 'ELHT00018', 'TXDALSTD', 'Critical Care and Pulmonary Consultants of Dallas', 'Adan', '', 'Mora', 'MD', 'Critical Care', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1376730549', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00915', 'ELHT00915', 'TXDALSTD', 'Lakewood Medical Center', 'John', 'R', 'Morgan', 'MD', 'Family Practice', '', '', NULL, 'O', '6331 Prospect Ave', 'Dallas', 'Dallas', 'TX', '75214', '2148219161', '2148241039', '6331 Prospect Ave', 'Dallas', 'Dallas', 'TX', '75214', '2148219161', '2148241039', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386608032', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.815, -96.7538, NULL, NULL),
('752536818', 'ELHT00916', 'ELHT00916', 'TXDALSTD', 'Lakewood Medical Center', 'John', 'R', 'Morgan', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386608032', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01139', 'ELHT01139', 'TXDALSTD', 'Cardiology Consultants of Texas', 'Melissa', 'M', 'Carry', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '621 N Hall St Ste 400', 'Dallas', 'Dallas', 'TX', '75226', '2148248721', '2142376529', '621 N Hall St Ste 400', 'Dallas', 'Dallas', 'TX', '75226', '2148248721', '2142376529', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386618510', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7879, -96.7802, NULL, NULL),
('752536818', 'ELHT01140', 'ELHT01140', 'TXDALSTD', 'Cardiology Consultants of Texas', 'Melissa', 'M', 'Carry', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386618510', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00131', 'ELHT00131', 'TXDALSTD', 'Cardiac Surgery Specialists', 'James', 'R', 'Edgerton', 'MD', 'Thoracic Surgery', '', '', NULL, 'O', '4716 Alliance Blvd Ste 310', 'Plano', 'Collin', 'TX', '75093', '4698006200', '4698006210', '4716 Alliance Blvd Ste 310', 'Plano', 'Collin', 'TX', '75093', '4698006200', '4698006210', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1386632909', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7926, NULL, NULL),
('752536818', 'ELHT00132', 'ELHT00132', 'TXDALSTD', 'Cardiac Surgery Specialists', 'James', 'R', 'Edgerton', 'MD', 'Thoracic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1386632909', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00917', 'ELHT00917', 'TXDALSTD', 'Headache Medicine Specialists of North Texas', 'Frederick', 'G', 'Freitag', 'DO', 'Family Practice', '', '', NULL, 'O', '9101 N Central Expwy Ste 400', 'Dallas', 'Dallas', 'TX', '75231', '2148209272', '2148209003', '9101 N Central Expy Ste 400', 'Dallas', 'Dallas', 'TX', '75231', '2148209272', '2148209003', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1386636272', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00918', 'ELHT00918', 'TXDALSTD', 'Headache Medicine Specialists of North Texas', 'Frederick', 'G', 'Freitag', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1386636272', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00019', 'ELHT00019', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'David', 'P', 'Myers', 'MD', 'Critical Care', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1386664548', 0, 'Y', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00020', 'ELHT00020', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'David', 'P', 'Myers', 'MD', 'Critical Care', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1386664548', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911982510', 'ELHT00919', 'ELHT00919', 'TXDALSTD', 'Family Medical Center at Terrell', 'Charles', 'C', 'Risinger', 'MD', 'Family Practice', '', '', NULL, 'O', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', '200 N Virginia St', 'Terrell', 'Kaufman', 'TX', '75160', '9725517500', '9725247418', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386665982', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7372, -96.2749, NULL, NULL),
('911982510', 'ELHT00920', 'ELHT00920', 'TXDALSTD', 'Family Medical Center at Terrell', 'Charles', 'C', 'Risinger', 'MD', 'Family Practice', '', '', NULL, 'B', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', '306 N Frances St', 'Terrell', 'Kaufman', 'TX', '75160', '9725242914', '9725245847', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1386665982', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01141', 'ELHT01141', 'TXDALSTD', 'Cardiovascular Consultants of North Texas', 'John', 'W R', 'Lawson', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1600 W College Ste 680', 'Grapevine', 'Tarrant', 'TX', '76051', '8179128400', '8179128410', '1600 W College Ste 680', 'Grapevine', 'Tarrant', 'TX', '76051', '8179128400', '8179128410', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor Regional Medical Center at Plano', NULL, NULL, 'HCFA|UB|', '1386674935', 0, 'N', 0, '2013-12-09', NULL, NULL, 32.9345, -97.0946, NULL, NULL),
('752536818', 'ELHT01142', 'ELHT01142', 'TXDALSTD', 'Cardiovascular Consultants of North Texas', 'John', 'W R', 'Lawson', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor Regional Medical Center at Plano', NULL, NULL, 'HCFA|UB|', '1386674935', 0, 'Y', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00163', 'ELHT00163', 'TXDALSTD', 'Radiosurgery Specialists', 'John', 'K', 'OConnor', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '3410 Worth St Ste 820', 'Dallas', 'Dallas', 'TX', '75246', '2148207400', '2148207300', '3410 Worth St Ste 820', 'Dallas', 'Dallas', 'TX', '75246', '2148207400', '2148207300', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1396709721', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7886, -96.779, NULL, NULL),
('911947573', 'ELHT00164', 'ELHT00164', 'TXDALSTD', 'Radiosurgery Specialists', 'John', 'K', 'OConnor', 'MD', 'Radiation Oncology', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208612', '2148208614', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208612', '2148208614', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1396709721', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00469', 'ELHT00469', 'TXDALSTD', '', 'Suma', '', 'Abraham', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2021 N MacArthur Blvd Ste 520', 'Irving', 'Dallas', 'TX', '75061', '9722512388', '9722512390', '2021 N MacArthur Blvd Ste 520', 'Irving', 'Dallas', 'TX', '75061', '9722512388', '9722512390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1396760039', 0, 'N', 0, '2014-01-30', NULL, NULL, 32.835, -96.9592, NULL, NULL),
('752536818', 'ELHT00470', 'ELHT00470', 'TXDALSTD', '', 'Suma', '', 'Abraham', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1396760039', 0, 'N', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('751037591', 'ELHT00705', 'ELHT00705', 'TXDALSTD', 'Baylor Senior Health Center Garland', 'Marina', 'T', 'Vengalil', 'MD', 'Geriatrics', '', '', NULL, 'O', '800 N Shiloh Rd', 'Garland', 'Dallas', 'TX', '75042', '9724875444', '9724853056', '800 N Shiloh Rd', 'Garland', 'Dallas', 'TX', '75042', '9724875444', '9724853056', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1396770947', 0, 'Y', 0, '2013-05-30', NULL, NULL, 32.9193, -96.6652, NULL, NULL),
('751037591', 'ELHT00706', 'ELHT00706', 'TXDALSTD', 'Baylor Senior Health Center Garland', 'Marina', 'T', 'Vengalil', 'MD', 'Geriatrics', '', '', NULL, 'B', 'PO Box 841540', 'Dallas', 'Dallas', 'TX', '75284', '9724953578', '9724969239', 'PO Box 841540', 'Dallas', 'Dallas', 'TX', '75284', '9724953578', '9724969239', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1396770947', 0, 'Y', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00077', 'ELHT00077', 'TXDALSTD', 'Pulmonary and Critical Care Associates of Garland', 'Ahmed', '', 'Raza', 'MD', 'Pulmonary', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 203', 'Garland', 'Dallas', 'TX', '75042', '9724941446', '9722765476', '700 Walter Reed Blvd Ste 203', 'Garland', 'Dallas', 'TX', '75042', '9724941446', '9722765476', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1396784997', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00078', 'ELHT00078', 'TXDALSTD', 'Pulmonary and Critical Care Associates of Garland', 'Ahmed', '', 'Raza', 'MD', 'Pulmonary', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1396784997', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00187', 'ELHT00187', 'TXDALSTD', '', 'Meredith', 'M', 'Adams', 'DO', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '1643 Lancaster Dr Ste 101A', 'Grapevine', 'Tarrant', 'TX', '76051', '8173292524', '8173292685', '1643 Lancaster Dr Ste 101A', 'Grapevine', 'Tarrant', 'TX', '76051', '8173292524', '8173292685', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1396790887', 0, 'N', 0, '2014-01-30', NULL, NULL, 32.9325, -97.0927, NULL, NULL),
('752536818', 'ELHT00188', 'ELHT00188', 'TXDALSTD', '', 'Meredith', 'M', 'Adams', 'DO', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1396790887', 0, 'N', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00471', 'ELHT00471', 'TXDALSTD', 'Plano IPCU', 'Abeezar', 'T', 'Shipchandler', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1407059595', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0144, -96.7924, NULL, NULL),
('752582845', 'ELHT00472', 'ELHT00472', 'TXDALSTD', 'Plano IPCU', 'Abeezar', 'T', 'Shipchandler', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1407059595', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00269', 'ELHT00269', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'Matthew', 'F', 'Nevitt', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3900 Junius St Ste 500', 'Dallas', 'Dallas', 'TX', '75246', '2148237090', '2148231644', '3900 Junius St Ste 500', 'Dallas', 'Dallas', 'TX', '75246', '2148237090', '2148231644', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-05-31', 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1407075617', 0, 'N', 0, '2013-07-31', NULL, NULL, 32.7913, -96.7775, NULL, NULL),
('752536818', 'ELHT00270', 'ELHT00270', 'TXDALSTD', 'Orthopedic Associates of Dallas', 'Matthew', 'F', 'Nevitt', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'PO Box 844128  ', 'Dallas', 'Dallas', 'TX', '75284', '2148181288', '2148181291', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1407075617', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752722718', 'ELHT00301', 'ELHT00301', 'TXDALSTD', 'Baylor Family Medical Center at Riverside', 'James', 'D', 'Peters', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', '2740 N Hwy 360 Ste 100', 'Grand Prairie', 'Dallas', 'TX', '75050', '9726068300', '9726064940', 'HTPN', 'TXHCPCHTPN', NULL, '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1407802259', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.797, -97.0554, NULL, NULL),
('752536818', 'ELHT00921', 'ELHT00921', 'TXDALSTD', 'Baylor Family Health Center at Richardson', 'Carey', 'B', 'Sharp', 'MD', 'Family Practice', '', '', NULL, 'O', '2520 N Central Expwy Ste 100', 'Richardson', 'Dallas', 'TX', '75080', '9722343311', '9726698072', '2520 North Central Expy Ste 100', 'Richardson', 'Dallas', 'TX', '75080', '9722343311', '9726698072', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1407823230', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.986, -96.7108, NULL, NULL),
('752536818', 'ELHT00922', 'ELHT00922', 'TXDALSTD', 'Baylor Family Health Center at Richardson', 'Carey', 'B', 'Sharp', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1407823230', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00707', 'ELHT00707', 'TXDALSTD', 'HealthTexas House Calls Program', 'Neeta', 'G', 'Nayak', 'MD', 'Geriatrics', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 651', 'Dallas', 'Dallas', 'TX', '75246', '2148209115', '2148209135', '3600 Gaston Ave Wadley Tower Ste 651', 'Dallas', 'Dallas', 'TX', '75246', '2148209115', '2148209135', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', '', '', '', 'HCFA|UB|', '1407887425', 0, 'Y', 0, '2014-04-17', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00708', 'ELHT00708', 'TXDALSTD', 'HealthTexas House Calls Program', 'Neeta', 'G', 'Nayak', 'MD', 'Geriatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', '', '', '', 'HCFA|UB|', '1407887425', 0, 'Y', 0, '2014-04-17', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00473', 'ELHT00473', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'James', 'A', 'Mitlyng', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407961337', 0, 'N', 0, '2013-07-30', NULL, NULL, 33.0138, -96.7917, NULL, NULL),
('752582845', 'ELHT00474', 'ELHT00474', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'James', 'A', 'Mitlyng', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407961337', 0, 'N', 0, '2013-07-30', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00475', 'ELHT00475', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Grady', 'G', 'Goodwin', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1407964158', 0, 'N', 0, '2013-12-26', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00476', 'ELHT00476', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Grady', 'G', 'Goodwin', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1407964158', 0, 'N', 0, '2013-12-26', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00477', 'ELHT00477', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'James', 'B', 'Chapman', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1407969785', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00478', 'ELHT00478', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'James', 'B', 'Chapman', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1407969785', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('752536818', 'ELHT00923', 'ELHT00923', 'TXDALSTD', 'Baylor Family Medicine at McKinney', 'Matthew', 'N', 'Green', 'MD', 'Family Practice', '', '', NULL, 'O', '5236 W University Dr Ste 1500', 'McKinney', 'Collin', 'TX', '75071', '4698005100', '4698005110', '5236 W University Dr Ste 1500', 'McKinney', 'Collin', 'TX', '75071', '4698005100', '4698005110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, NULL, NULL, 'HCFA|UB|', '1417005828', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.2183, -96.684, NULL, NULL),
('752536818', 'ELHT00924', 'ELHT00924', 'TXDALSTD', 'Baylor Family Medicine at McKinney', 'Matthew', 'N', 'Green', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, NULL, NULL, 'HCFA|UB|', '1417005828', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00479', 'ELHT00479', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Ifeoma', 'A', 'Kalu', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417150509', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.8341, -96.9592, NULL, NULL),
('752536818', 'ELHT00480', 'ELHT00480', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Ifeoma', 'A', 'Kalu', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417150509', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00925', 'ELHT00925', 'TXDALSTD', 'Health Texas Provider Network', 'Richard', 'K', 'Bellinger', 'MD', 'Family Practice', '', '', NULL, 'O', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417906488', 0, 'N', 0, '2013-07-30', NULL, NULL, 32.8649, -96.4407, NULL, NULL),
('752536818', 'ELHT00926', 'ELHT00926', 'TXDALSTD', 'Health Texas Provider Network', 'Richard', 'K', 'Bellinger', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417906488', 0, 'Y', 0, '2013-07-30', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00271', 'ELHT00271', 'TXDALSTD', 'Hip Preservation Center', 'Hal', 'D', 'Martin', 'DO', 'Orthopedic Surgery', '', '', NULL, 'O', '411 N Washington Ave Ste 7300', 'Dallas', 'Dallas', 'TX', '75246', '2148209520', '2148207744', '411 N Washington Ave Ste 7300', 'Dallas', 'Dallas', 'TX', '75246', '2148209520', '2148207744', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1417929563', 0, 'N', 0, '2013-05-01', NULL, NULL, 32.7885, -96.7752, NULL, NULL),
('911947573', 'ELHT00272', 'ELHT00272', 'TXDALSTD', 'Hip Preservation Center', 'Hal', 'D', 'Martin', 'DO', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1417929563', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00481', 'ELHT00481', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Steven', 'R', 'Bray', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-31', 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1417971474', 0, 'N', 0, '2013-12-26', NULL, NULL, 32.79, -96.7806, NULL, NULL),
('911947573', 'ELHT00482', 'ELHT00482', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Steven', 'R', 'Bray', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-31', 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1417971474', 0, 'N', 0, '2013-12-26', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00041', 'ELHT00041', 'TXDALSTD', 'Baylor Endocrine Center', 'Priscilla', 'A', 'Hollander', 'MD', 'Endocrinology', '', '', NULL, 'O', '3600 Gaston Ave Ste 656', 'Dallas', 'Dallas', 'TX', '75246', '2148203466', '2148208944', '3600 Gaston Ave Ste 656', 'Dallas', 'Dallas', 'TX', '75246', '2148203466', '2148208944', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417988098', 0, 'N', 0, '2013-04-05', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00042', 'ELHT00042', 'TXDALSTD', 'Baylor Endocrine Center', 'Priscilla', 'A', 'Hollander', 'MD', 'Endocrinology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417988098', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00323', 'ELHT00323', 'TXDALSTD', 'Neuro Oncology Associates', 'Karen', 'L', 'Fink', 'MD', 'Neurology', '', '', NULL, 'O', '3410 Worth St Ste 820', 'Dallas', 'Dallas', 'TX', '75246', '2148208690', '2148208691', '3410 Worth St Ste 820', 'Dallas', 'Dallas', 'TX', '75246', '2148208690', '2148208691', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417993841', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7886, -96.779, NULL, NULL),
('911947573', 'ELHT00324', 'ELHT00324', 'TXDALSTD', 'Neuro Oncology Associates', 'Karen', 'L', 'Fink', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208612', '2148208614', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208612', '2148208614', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417993841', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00483', 'ELHT00483', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Mildred', 'A', 'McAfee', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417994823', 0, 'N', 0, '2013-05-23', NULL, NULL, 33.0138, -96.7917, NULL, NULL),
('752582845', 'ELHT00484', 'ELHT00484', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Mildred', 'A', 'McAfee', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417994823', 0, 'N', 0, '2013-05-28', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00485', 'ELHT00485', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'David', 'M', 'Cantrell', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1417997610', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.8341, -96.9592, NULL, NULL),
('752536818', 'ELHT00486', 'ELHT00486', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'David', 'M', 'Cantrell', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1417997610', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00927', 'ELHT00927', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'Robert', 'N', 'Stark', 'MD', 'Family Practice', '', '', NULL, 'O', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', '6435 South FM549 Ste 201', 'Heath', 'Rockwall', 'TX', '75032', '9727719155', '9727712390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-09-05', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427035484', 0, 'N', 0, '2013-09-16', NULL, NULL, 32.8649, -96.4407, NULL, NULL),
('752536818', 'ELHT00928', 'ELHT00928', 'TXDALSTD', 'Baylor Family Medical Center at Rockwall', 'Robert', 'N', 'Stark', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-09-05', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427035484', 0, 'Y', 0, '2013-09-16', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00487', 'ELHT00487', 'TXDALSTD', 'MedProvider', 'Paul', 'A', 'Muncy', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 420', 'Dallas', 'Dallas', 'TX', '75204', '2148285000', '2148285021', '3434 Swiss Ave Ste 420', 'Dallas', 'Dallas', 'TX', '75204', '2148285000', '2148285021', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1427061555', 0, 'N', 0, '2013-06-14', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752582845', 'ELHT00489', 'ELHT00489', 'TXDALSTD', 'Plano IPCU', 'Korie', 'L', 'Flippo', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1427071612', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0144, -96.7924, NULL, NULL),
('752582845', 'ELHT00490', 'ELHT00490', 'TXDALSTD', 'Plano IPCU', 'Korie', 'L', 'Flippo', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1427071612', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00223', 'ELHT00223', 'TXDALSTD', 'Southlake Family Medicine', 'Erica', 'J', 'Zwernemann', 'MD', 'Pediatrics', '', '', NULL, 'O', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1427079300', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.941, -97.1405, NULL, NULL),
('752536818', 'ELHT00224', 'ELHT00224', 'TXDALSTD', 'Southlake Family Medicine', 'Erica', 'J', 'Zwernemann', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1427079300', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00225', 'ELHT00225', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Waxahachie', 'Haley', 'E', 'Wagner', 'DO', 'Pediatrics', '', '', NULL, 'O', '505 N Hwy 77 Ste 200', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231686', '9729377731', '505 N Hwy 77 Ste 200', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231686', '9729377731', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1427092980', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.3965, -96.8453, NULL, NULL),
('911947573', 'ELHT00226', 'ELHT00226', 'TXDALSTD', 'Baylor Family Medical Center at Ellis County Waxahachie', 'Haley', 'E', 'Wagner', 'DO', 'Pediatrics', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729231686', '9729239268', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1427092980', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00491', 'ELHT00491', 'TXDALSTD', 'MedProvider', 'Paul', 'C', 'Chung', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 330', 'Dallas', 'Dallas', 'TX', '75204', '2148285775', '2148285071', '3434 Swiss Ave Ste 330', 'Dallas', 'Dallas', 'TX', '75204', '2148285775', '2148285071', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', 'Baylor University Medical Center', NULL, NULL, 'HCFA|UB|', '1427165992', 0, 'N', 0, '2013-07-23', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT00493', 'ELHT00493', 'TXDALSTD', 'McKinney Inpatient Care Unit', 'Honey', 'C', 'Cheruiyot', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5252 W University Dr', 'McKinney', 'Collin', 'TX', '75071', '4697646950', '4697646954', '5252 W University Dr', 'McKinney', 'Collin', 'TX', '75071', '4697646950', '4697646954', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427198373', 0, 'Y', 0, '2013-05-01', NULL, NULL, 33.2183, -96.6841, NULL, NULL),
('752536818', 'ELHT00494', 'ELHT00494', 'TXDALSTD', 'McKinney Inpatient Care Unit', 'Honey', 'C', 'Cheruiyot', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427198373', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00157', 'ELHT00157', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Su', '', 'Yin', 'MD', 'Rheumatology', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1427252394', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00158', 'ELHT00158', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Su', '', 'Yin', 'MD', 'Rheumatology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1427252394', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00929', 'ELHT00929', 'TXDALSTD', 'Southlake Family Medicine', 'Stephen', 'D', 'Kindrick', 'DO', 'Family Practice', '', '', NULL, 'O', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1427266857', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.941, -97.1405, NULL, NULL),
('752536818', 'ELHT00930', 'ELHT00930', 'TXDALSTD', 'Southlake Family Medicine', 'Stephen', 'D', 'Kindrick', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1427266857', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00931', 'ELHT00931', 'TXDALSTD', 'Baylor Family Medicine at Keller', 'Kevin', 'S', 'Liu', 'MD', 'Family Practice', '', '', NULL, 'O', '601 S Main St Ste 200', 'Keller', 'Tarrant', 'TX', '76248', '8177536888', '8177536885', '601 S Main St Ste 200', 'Keller', 'Tarrant', 'TX', '76248', '8177536888', '8177536885', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Emergency Medical Center at Keller', NULL, '', NULL, 'HCFA|UB|', '1437167046', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9271, -97.2541, NULL, NULL),
('752536818', 'ELHT00932', 'ELHT00932', 'TXDALSTD', 'Baylor Family Medicine at Keller', 'Kevin', 'S', 'Liu', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Emergency Medical Center at Keller', NULL, '', NULL, 'HCFA|UB|', '1437167046', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00495', 'ELHT00495', 'TXDALSTD', 'Baylor Health Center at Park Cities', 'Elisabeth', 'A', 'Tilleros', 'MD', 'Internal Medicine', '', '', NULL, 'O', '9101 N Central Expwy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', '9101 N Central Expy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1437252947', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00496', 'ELHT00496', 'TXDALSTD', 'Baylor Health Center at Park Cities', 'Elisabeth', 'A', 'Tilleros', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1437252947', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00767', 'ELHT00767', 'TXDALSTD', 'Baylor Community Care at Worth Street', 'Daniel', 'E', 'Polter', 'MD', 'Gastroenterology', '', '', NULL, 'O', '4001 Worth St', 'Dallas', 'Dallas', 'TX', '75246', '2148281745', '2148281734', '4001 Worth St', 'Dallas', 'Dallas', 'TX', '75246', '2148281745', '2148281734', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1447219092', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7912, -96.7759, NULL, NULL),
('752536818', 'ELHT00768', 'ELHT00768', 'TXDALSTD', 'Baylor Community Care at Worth Street', 'Daniel', 'E', 'Polter', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1447219092', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00189', 'ELHT00189', 'TXDALSTD', 'Physiatric Medicine Associates', 'Frank', 'E', 'McDonald', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'O', '3301 Swiss Ave', 'Dallas', 'Dallas', 'TX', '75204', '2148209800', '2148209878', '3301 Swiss Ave', 'Dallas', 'Dallas', 'TX', '75204', '2148209800', '2148209878', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1447269071', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7904, -96.7831, NULL, NULL),
('752536818', 'ELHT00190', 'ELHT00190', 'TXDALSTD', 'Physiatric Medicine Associates', 'Frank', 'E', 'McDonald', 'MD', 'Physical Medicine and Rehabilitation', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1447269071', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00497', 'ELHT00497', 'TXDALSTD', 'MedProvider', 'Dean', 'C', 'Dimmitt', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 206', 'Dallas', 'Dallas', 'TX', '75204', '2148285660', '2148285659', '3434 Swiss Ave Ste 206', 'Dallas', 'Dallas', 'TX', '75204', '2148285660', '2148285659', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', 'Baylor Specialty Hospital', NULL, NULL, 'HCFA|UB|', '1447334800', 0, 'N', 0, '2013-06-14', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752536818', 'ELHT00933', 'ELHT00933', 'TXDALSTD', 'Baylor Community Care at Ft Worth', 'Alexander', 'P', 'Vilaythong', 'DO', 'Family Practice', '', '', NULL, 'O', '1650 Magnolia Ave Ste 207', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179128000', '8179128010', '1650 Magnolia Ave Ste 207', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179128000', '8179128010', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447410535', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7307, -97.3445, NULL, NULL),
('752536818', 'ELHT00934', 'ELHT00934', 'TXDALSTD', 'Baylor Community Care at Ft Worth', 'Alexander', 'P', 'Vilaythong', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447410535', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00499', 'ELHT00499', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'David', 'D', 'Boltan', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1447468624', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.8341, -96.9592, NULL, NULL),
('752536818', 'ELHT00500', 'ELHT00500', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'David', 'D', 'Boltan', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1447468624', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00501', 'ELHT00501', 'TXDALSTD', 'Plano IPCU', 'Ye Olivia', '', 'Xu Cai', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457314635', 0, 'N', 0, '2013-07-30', NULL, NULL, 33.0136, -96.7882, NULL, NULL),
('752582845', 'ELHT00502', 'ELHT00502', 'TXDALSTD', 'Plano IPCU', 'Ye Olivia', '', 'Xu Cai', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457314635', 0, 'N', 0, '2013-07-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00935', 'ELHT00935', 'TXDALSTD', 'Family Medical Center at Garland', 'John', 'M', 'Wiprud', 'MD', 'Family Practice', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 140', 'Garland', 'Dallas', 'TX', '75042', '9722726561', '9722763067', '601 Clara Barton Blvd Ste 140', 'Garland', 'Dallas', 'TX', '75042', '9722726561', '9722763067', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1457373714', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00936', 'ELHT00936', 'TXDALSTD', 'Family Medical Center at Garland', 'John', 'M', 'Wiprud', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1457373714', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00503', 'ELHT00503', 'TXDALSTD', 'Southlake Family Medicine', 'Gerald', 'J', 'Harder', 'MD', 'Internal Medicine', '', '', NULL, 'O', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1457375396', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.941, -97.1405, NULL, NULL),
('752536818', 'ELHT00504', 'ELHT00504', 'TXDALSTD', 'Southlake Family Medicine', 'Gerald', 'J', 'Harder', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1457375396', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00505', 'ELHT00505', 'TXDALSTD', 'Supportive and Palliative Care Clinic at BUMC', 'Roberto', 'C', 'de la Cruz', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3600 Gaston Ave   Barnett Tower Ste 605', 'Dallas', 'Dallas', 'TX', '75246', '2148209248', '2148209458', '3600 Gaston Ave   Ste 605 Barnett Tower', 'Dallas', 'Dallas', 'TX', '75246', '2148209248', '2148209458', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1457381741', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00506', 'ELHT00506', 'TXDALSTD', 'Supportive and Palliative Care Clinic at BUMC', 'Roberto', 'C', 'de la Cruz', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1457381741', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00937', 'ELHT00937', 'TXDALSTD', 'Southlake Family Medicine', 'Kelly', 'E', 'Cunningham', 'MD', 'Family Practice', '', '', NULL, 'O', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1457491227', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.941, -97.1405, NULL, NULL),
('752536818', 'ELHT00938', 'ELHT00938', 'TXDALSTD', 'Southlake Family Medicine', 'Kelly', 'E', 'Cunningham', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1457491227', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00043', 'ELHT00043', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Sarika', 'B', 'Shivnani', 'MD', 'Endocrinology', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1457553794', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00044', 'ELHT00044', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Sarika', 'B', 'Shivnani', 'MD', 'Endocrinology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1457553794', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01143', 'ELHT01143', 'TXDALSTD', 'The Heart Group', 'William', 'T', 'Gray', 'DO', 'Cardiovascular Disease', '', '', NULL, 'O', '5236 W University Dr Ste 2000', 'McKinney', 'Collin', 'TX', '75071', '4698005350', '4698005386', '5236 W University Dr Ste 2000', 'McKinney', 'Collin', 'TX', '75071', '4698005350', '4698005386', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, '', '', 'HCFA|UB|', '1467407197', 0, 'N', 0, '2013-12-09', NULL, NULL, 33.2211, -96.6826, NULL, NULL),
('752536818', 'ELHT01144', 'ELHT01144', 'TXDALSTD', 'The Heart Group', 'William', 'T', 'Gray', 'DO', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, '', '', 'HCFA|UB|', '1467407197', 0, 'Y', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00507', 'ELHT00507', 'TXDALSTD', 'Plano IPCU', 'Sayantani', 'C', 'Lahiri', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', '4700 Alliance Blvd Ste 400', 'Plano', 'Collin', 'TX', '75093', '4698146631', '4698143110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1467463596', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0144, -96.7924, NULL, NULL),
('752582845', 'ELHT00508', 'ELHT00508', 'TXDALSTD', 'Plano IPCU', 'Sayantani', 'C', 'Lahiri', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1467463596', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00509', 'ELHT00509', 'TXDALSTD', 'MedProvider', 'Ruby', 'E', 'Kassanoff', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 410', 'Dallas', 'Dallas', 'TX', '75204', '2148285010', '2148285011', '3434 Swiss Ave Ste 410', 'Dallas', 'Dallas', 'TX', '75204', '2148285010', '2148285011', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-06-30', 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1467464594', 0, 'N', 0, '2013-07-31', NULL, NULL, 32.7913, -96.7821, NULL, NULL),
('752536818', 'ELHT01203', 'ELHT01203', 'TXDALSTD', 'Cardiovascular Consultants of North Texas', 'David', 'M', 'Scherer', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1600 W College Ste 680', 'Grapevine', 'Tarrant', 'TX', '76051', '8179128400', '8179128410', '1600 W College Ste 680', 'Grapevine', 'Tarrant', 'TX', '76051', '8179128400', '8179128410', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor Regional Medical Center at Plano', NULL, NULL, 'HCFA|UB|', '1467482083', 0, 'N', 0, '2013-12-09', NULL, NULL, 32.9345, -97.0946, NULL, NULL),
('752536818', 'ELHT01204', 'ELHT01204', 'TXDALSTD', 'Cardiovascular Consultants of North Texas', 'David', 'M', 'Scherer', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor Regional Medical Center at Plano', NULL, NULL, 'HCFA|UB|', '1467482083', 0, 'Y', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00939', 'ELHT00939', 'TXDALSTD', '', 'Ruth', 'A', 'Adell', 'DO', 'Family Practice', '', '', NULL, 'O', '294 Uptown Blvd Ste 100', 'Cedar Hill', 'Dallas', 'TX', '75104', '9722933569', '9722999513', '294 Uptown Blvd Ste 100', 'Cedar Hill', 'Dallas', 'TX', '75104', '9722933569', '9722999513', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1467494807', 0, 'N', 0, '2014-01-30', NULL, NULL, 32.5923, -96.951, NULL, NULL),
('752536818', 'ELHT00940', 'ELHT00940', 'TXDALSTD', '', 'Ruth', 'A', 'Adell', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1467494807', 0, 'Y', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00325', 'ELHT00325', 'TXDALSTD', 'Neurology Associates of Grapevine', 'Madhuri', 'L', 'Koganti', 'MD', 'Neurology', '', '', NULL, 'O', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-11-07', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1467557124', 0, 'N', 0, '2013-12-09', NULL, NULL, 32.8864, -97.1526, NULL, NULL),
('752536818', 'ELHT00326', 'ELHT00326', 'TXDALSTD', 'Neurology Associates of Grapevine', 'Madhuri', 'L', 'Koganti', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-11-07', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1467557124', 0, 'N', 0, '2013-12-09', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01205', 'ELHT01205', 'TXDALSTD', 'Cottonwood Cardiology', 'James', 'M', 'Yau', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1110 Cottonwood Ln Ste 105', 'Irving', 'Dallas', 'TX', '75038', '9726072525', '9722528837', '1110 Cottonwood Ln Ste 105', 'Irving', 'Dallas', 'TX', '75038', '9726072525', '9722528837', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1467654764', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8652, -96.9601, NULL, NULL),
('752536818', 'ELHT01206', 'ELHT01206', 'TXDALSTD', 'Cottonwood Cardiology', 'James', 'M', 'Yau', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1467654764', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00941', 'ELHT00941', 'TXDALSTD', '', 'Rajan', 'S', 'Kohli', 'MD', 'Family Practice', '', '', NULL, 'O', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', '1405 W Jefferson St', 'Waxahachie', 'Ellis', 'TX', '75165', '9729237144', '9729237145', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1477534436', 0, 'N', 0, '2014-01-24', NULL, NULL, 32.3968, -96.865, NULL, NULL),
('911947573', 'ELHT00942', 'ELHT00942', 'TXDALSTD', '', 'Rajan', 'S', 'Kohli', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, '', NULL, 'HCFA|UB|', '1477534436', 0, 'Y', 0, '2014-01-24', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01145', 'ELHT01145', 'TXDALSTD', 'Grapevine Cardiology', 'Vikas', 'C', 'Jain', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1643 Lancaster Dr Ste 203', 'Grapevine', 'Tarrant', 'TX', '76051', '8173297670', '8174160145', '1643 Lancaster Dr Ste 203', 'Grapevine', 'Tarrant', 'TX', '76051', '8173297670', '8174160145', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-10-31', 0, 0, 0, 'Baylor Medical Center at Irving', 'Baylor Medical Center at Waxahachie', NULL, NULL, 'HCFA|UB|', '1477555092', 0, 'N', 0, '2013-12-09', NULL, NULL, 32.9321, -97.0939, NULL, NULL),
('752536818', 'ELHT01146', 'ELHT01146', 'TXDALSTD', 'Grapevine Cardiology', 'Vikas', 'C', 'Jain', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', 'Baylor Medical Center at Waxahachie', NULL, NULL, 'HCFA|UB|', '1477555092', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00511', 'ELHT00511', 'TXDALSTD', 'Southlake Family Medicine', 'Stacey', 'L', 'Hatcher', 'MD', 'Internal Medicine', '', '', NULL, 'O', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1477567238', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.941, -97.1405, NULL, NULL),
('752536818', 'ELHT00512', 'ELHT00512', 'TXDALSTD', 'Southlake Family Medicine', 'Stacey', 'L', 'Hatcher', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1477567238', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00513', 'ELHT00513', 'TXDALSTD', 'Baylor Internal Medicine Associates at McKinney', 'Janet', 'I', 'Lin', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5236 W University Dr Ste 2000', 'McKinney', 'Collin', 'TX', '75071', '4698005000', '4698005010', '5236 W University Dr Ste 2000', 'McKinney', 'Collin', 'TX', '75071', '4698005000', '4698005010', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, NULL, NULL, 'HCFA|UB|', '1477588358', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.2183, -96.684, NULL, NULL),
('752536818', 'ELHT00514', 'ELHT00514', 'TXDALSTD', 'Baylor Internal Medicine Associates at McKinney', 'Janet', 'I', 'Lin', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, NULL, NULL, 'HCFA|UB|', '1477588358', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT01107', 'ELHT01107', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Mark', 'D', 'Thieberg', 'MD', 'Dermatology', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1477669992', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT01108', 'ELHT01108', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Mark', 'D', 'Thieberg', 'MD', 'Dermatology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1477669992', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00327', 'ELHT00327', 'TXDALSTD', 'Neurology Hospitalist Group', 'David', 'F', 'Moore', 'MD', 'Neurology', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 1155', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', '3600 Gaston Ave Wadley Ste 1155 ', 'Dallas', 'Dallas', 'TX', '75246', '2148204561', '2148204562', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1477742906', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00328', 'ELHT00328', 'TXDALSTD', 'Neurology Hospitalist Group', 'David', 'F', 'Moore', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', NULL, 'HCFA|UB|', '1477742906', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00943', 'ELHT00943', 'TXDALSTD', 'Baylor Family Health Center at Richardson', 'Katrina', 'M', 'Bradford', 'MD', 'Family Practice', '', '', NULL, 'O', '2520 N Central Expwy Ste 100', 'Richardson', 'Dallas', 'TX', '75080', '9722343311', '9726698072', '2520 North Central Expy Ste 100', 'Richardson', 'Dallas', 'TX', '75080', '9722343311', '9726698072', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1487619334', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.986, -96.7108, NULL, NULL),
('752536818', 'ELHT00944', 'ELHT00944', 'TXDALSTD', 'Baylor Family Health Center at Richardson', 'Katrina', 'M', 'Bradford', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1487619334', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01147', 'ELHT01147', 'TXDALSTD', 'The Heart Group', 'Deepika', '', 'Gopalakrishnan', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1487646048', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('752536818', 'ELHT01148', 'ELHT01148', 'TXDALSTD', 'The Heart Group', 'Deepika', '', 'Gopalakrishnan', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1487646048', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('752536818', 'ELHT00515', 'ELHT00515', 'TXDALSTD', 'Baylor Health Center at Park Cities', 'Michelle', 'M', 'Ho', 'MD', 'Internal Medicine', '', '', NULL, 'O', '9101 N Central Expwy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', '9101 N Central Expy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487682118', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00516', 'ELHT00516', 'TXDALSTD', 'Baylor Health Center at Park Cities', 'Michelle', 'M', 'Ho', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1487682118', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00273', 'ELHT00273', 'TXDALSTD', 'Orthopaedic Trauma Associates of North Texas', 'Alan', 'L', 'Jones', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3409 Worth St Ste 300', 'Dallas', 'Dallas', 'TX', '75246', '2148208350', '2148208355', '3409 Worth St Ste 300', 'Dallas', 'Dallas', 'TX', '75246', '2148208350', '2148208355', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1487682316', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7886, -96.779, NULL, NULL),
('911947573', 'ELHT00274', 'ELHT00274', 'TXDALSTD', 'Orthopaedic Trauma Associates of North Texas', 'Alan', 'L', 'Jones', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1487682316', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00517', 'ELHT00517', 'TXDALSTD', 'Health Texas Provider Network', 'Carlos', '', 'Bazaldua', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2020 West Hwy 114 Ste 200', 'Grapevine', 'Tarrant', 'TX', '76051', '8174167214', '8174164694', '2020 West Hwy 114 Ste 200', 'Grapevine', 'Tarrant', 'TX', '76051', '8174167214', '8174164694', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-07-14', 0, 0, 0, 'Baylor Regional Medical Center at Grapevine', NULL, NULL, NULL, 'HCFA|UB|', '1487683744', 0, 'N', 0, '2013-07-31', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00518', 'ELHT00518', 'TXDALSTD', 'Health Texas Provider Network', 'Carlos', '', 'Bazaldua', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Grapevine', NULL, NULL, NULL, 'HCFA|UB|', '1487683744', 0, 'Y', 0, '2013-06-12', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00519', 'ELHT00519', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Manoj', 'K', 'Donthineni', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1497708093', 0, 'Y', 0, '2013-05-01', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00520', 'ELHT00520', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Manoj', 'K', 'Donthineni', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1497708093', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01207', 'ELHT01207', 'TXDALSTD', 'Cardiology Consultants of Texas', 'James', 'W', 'Choi', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '621 N Hall St Ste 400', 'Dallas', 'Dallas', 'TX', '75226', '2148248721', '2142376529', '621 N Hall St Ste 400', 'Dallas', 'Dallas', 'TX', '75226', '2148248721', '2142376529', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor University Medical Center', NULL, NULL, 'HCFA|UB|', '1497729123', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7879, -96.7802, NULL, NULL),
('752536818', 'ELHT01208', 'ELHT01208', 'TXDALSTD', 'Cardiology Consultants of Texas', 'James', 'W', 'Choi', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', 'Baylor University Medical Center', NULL, NULL, 'HCFA|UB|', '1497729123', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT01149', 'ELHT01149', 'TXDALSTD', 'The Heart Group', 'J. Edward', '', 'Rosenthal', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', '7777 Forest Ln Ste A202', 'Dallas', 'Dallas', 'TX', '75230', '9725667733', '9727205803', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1497747059', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('752536818', 'ELHT01150', 'ELHT01150', 'TXDALSTD', 'The Heart Group', 'J. Edward', '', 'Rosenthal', 'MD', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1497747059', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00945', 'ELHT00945', 'TXDALSTD', 'Family Medical Center at Baylor', 'Melanie', 'L', 'Reed', 'MD', 'Family Practice', '', '', NULL, 'O', '3600 Gaston Ave Barnett Tower Ste 1109', 'Dallas', 'Dallas', 'TX', '75246', '2148208300', '2148208313', '3600 Gaston Ave Barnett Ste 1109', 'Dallas', 'Dallas', 'TX', '75246', '2148208300', '2148208313', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497786602', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00946', 'ELHT00946', 'TXDALSTD', 'Family Medical Center at Baylor', 'Melanie', 'L', 'Reed', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497786602', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00521', 'ELHT00521', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Laura', 'C', 'Demoya', 'MD', 'Hospitalist', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497863187', 0, 'Y', 0, '2013-04-26', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('911947573', 'ELHT00522', 'ELHT00522', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Laura', 'C', 'Demoya', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497863187', 0, 'Y', 0, '2013-04-26', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00275', 'ELHT00275', 'TXDALSTD', 'Orthopaedic Trauma Associates of North Texas', 'Casey', 'A', 'Cates', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '3409 Worth St Ste 300', 'Dallas', 'Dallas', 'TX', '75246', '2148208350', '2148208355', '3409 Worth St Ste 300', 'Dallas', 'Dallas', 'TX', '75246', '2148208350', '2148208355', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1497872774', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7886, -96.779, NULL, NULL),
('911947573', 'ELHT00276', 'ELHT00276', 'TXDALSTD', 'Orthopaedic Trauma Associates of North Texas', 'Casey', 'A', 'Cates', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148208350', '2148208355', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, NULL, NULL, 'HCFA|UB|', '1497872774', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00731', 'ELHT00731', 'TXDALSTD', 'Texas Surgical Specialists', 'Katrina', '', 'Emmett', 'MD', 'General Surgery', '', '', NULL, 'O', '1305 W Jefferson Ste 120', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231457', '9729231304', '1305 W Jefferson Ste 120', 'Waxahachie', 'Ellis', 'TX', '75165', '9729231457', '9729231304', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1508067760', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.3961, -96.8638, NULL, NULL),
('911947573', 'ELHT00732', 'ELHT00732', 'TXDALSTD', 'Texas Surgical Specialists', 'Katrina', '', 'Emmett', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1508067760', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00947', 'ELHT00947', 'TXDALSTD', 'Colleyville Family Medicine', 'Marilyn', 'K', 'Justice', 'MD', 'Family Practice', '', '', NULL, 'O', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', '5232 Colleyville Blvd Ste 100', 'Colleyville', 'Tarrant', 'TX', '76034', '8174989920', '8174980635', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508801689', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8864, -97.1519, NULL, NULL),
('752536818', 'ELHT00948', 'ELHT00948', 'TXDALSTD', 'Colleyville Family Medicine', 'Marilyn', 'K', 'Justice', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508801689', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00949', 'ELHT00949', 'TXDALSTD', 'Baylor Family Medicine at Uptown', 'Anitha', 'D', 'Veerasamy', 'MD', 'Family Practice', '', '', NULL, 'O', '4161 McKinney Ave Ste 300', 'Dallas', 'Dallas', 'TX', '75204', '2142196655', '2142196660', '4161 McKinney Ave Ste 300', 'Dallas', 'Dallas', 'TX', '75204', '2142196655', '2142196660', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, '', NULL, 'HCFA|UB|', '1508841768', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8156, -96.7912, NULL, NULL),
('752536818', 'ELHT00950', 'ELHT00950', 'TXDALSTD', 'Baylor Family Medicine at Uptown', 'Anitha', 'D', 'Veerasamy', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Uptown', NULL, '', NULL, 'HCFA|UB|', '1508841768', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00951', 'ELHT00951', 'TXDALSTD', 'North Texas Health Care Associates Family Medicine', 'Douglas', 'M', 'Cluff', 'MD', 'Family Practice', '', '', NULL, 'O', '400 W IH 635 Ste 210', 'Irving', 'Dallas', 'TX', '75063', '9728692772', '9728691747', '400 W IH 635 Ste 210', 'Irving', 'Dallas', 'TX', '75063', '9728692772', '9728691747', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1508890914', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9125, -96.9492, NULL, NULL),
('752536818', 'ELHT00952', 'ELHT00952', 'TXDALSTD', 'North Texas Health Care Associates Family Medicine', 'Douglas', 'M', 'Cluff', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1508890914', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00523', 'ELHT00523', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Aaron', 'L', 'Samsula', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1508971011', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00524', 'ELHT00524', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Aaron', 'L', 'Samsula', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1508971011', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00953', 'ELHT00953', 'TXDALSTD', 'Baylor Family Health Center at Richardson', 'Shubha', 'P', 'Bhat', 'MD', 'Family Practice', '', '', NULL, 'O', '2520 N Central Expwy Ste 100', 'Richardson', 'Dallas', 'TX', '75080', '9722343311', '9726698072', '2520 North Central Expy Ste 100', 'Richardson', 'Dallas', 'TX', '75080', '9722343311', '9726698072', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1518170380', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.986, -96.7108, NULL, NULL),
('752536818', 'ELHT00954', 'ELHT00954', 'TXDALSTD', 'Baylor Family Health Center at Richardson', 'Shubha', 'P', 'Bhat', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1518170380', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00769', 'ELHT00769', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Thomas', 'G', 'Van Dinter', 'MD', 'Gastroenterology', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1518184365', 0, 'N', 0, '2014-01-08', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00770', 'ELHT00770', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Thomas', 'G', 'Van Dinter', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1518184365', 0, 'Y', 0, '2014-01-08', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00955', 'ELHT00955', 'TXDALSTD', 'Baylor Family Medicine Southwest', 'Joseph', 'W', 'Cappel', 'MD', 'Family Practice', '', '', NULL, 'O', '5701 Bryant Irvin Rd Ste 301', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173616200', '8173616201', '5701 Bryant Irvin Rd Ste 301', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173616200', '8173616201', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', NULL, 'HCFA|UB|', '1518916063', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.6664, -97.4199, NULL, NULL),
('752536818', 'ELHT00956', 'ELHT00956', 'TXDALSTD', 'Baylor Family Medicine Southwest', 'Joseph', 'W', 'Cappel', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', NULL, 'HCFA|UB|', '1518916063', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00957', 'ELHT00957', 'TXDALSTD', 'Baylor Family Medicine at Coppell', 'Kamna', '', 'Kapil', 'MD', 'Family Practice', '', '', NULL, 'O', '878 S Denton Tap Rd Ste 250', 'Coppell', 'Dallas', 'TX', '75019', '9727456590', '9727456595', '878 S Denton Tap Rd Ste 250', 'Coppell', 'Dallas', 'TX', '75019', '9727456590', '9727456595', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518933027', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9492, -96.9934, NULL, NULL),
('752536818', 'ELHT00958', 'ELHT00958', 'TXDALSTD', 'Baylor Family Medicine at Coppell', 'Kamna', '', 'Kapil', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518933027', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00525', 'ELHT00525', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'D Crockett', '', 'Thigpen', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1528013737', 0, 'Y', 0, '2013-05-01', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00526', 'ELHT00526', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'D Crockett', '', 'Thigpen', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1528013737', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('030374787', 'ELHT00733', 'ELHT00733', 'TXDALSTD', 'Surgical Institute', 'Howard', 'C', 'Derrick', 'MD', 'General Surgery', '', '', NULL, 'O', '3600 Gaston Ave Wadley Tower Ste 958', 'Dallas', 'Dallas', 'TX', '75246', '2148266276', '2148266223', '3600 Gaston Ave Wadley Tower Ste 958', 'Dallas', 'Dallas', 'TX', '75246', '2148266276', '2148266223', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', 'Baylor University Medical Center', NULL, NULL, 'HCFA|UB|', '1528086907', 0, 'N', 0, '2013-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00527', 'ELHT00527', 'TXDALSTD', 'Baylor Health Center at Park Cities', 'David', 'P', 'Hominick', 'MD', 'Internal Medicine', '', '', NULL, 'O', '9101 N Central Expwy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', '9101 N Central Expy Ste 300', 'Dallas', 'Dallas', 'TX', '75231', '2143632305', '2143632608', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528091188', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.873, -96.7706, NULL, NULL),
('752536818', 'ELHT00528', 'ELHT00528', 'TXDALSTD', 'Baylor Health Center at Park Cities', 'David', 'P', 'Hominick', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528091188', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00529', 'ELHT00529', 'TXDALSTD', 'Supportive and Palliative Care Clinic at BUMC', 'Susan', 'E', 'Kohl', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3600 Gaston Ave Barnett Tower Ste 605', 'Dallas', 'Dallas', 'TX', '75246', '2148209248', '2148209458', '3600 Gaston Ave Barnett Ste 605', 'Dallas', 'Dallas', 'TX', '75246', '2148209248', '2148209458', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528098811', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7913, -96.7799, NULL, NULL),
('752536818', 'ELHT00530', 'ELHT00530', 'TXDALSTD', 'Supportive and Palliative Care Clinic at BUMC', 'Susan', 'E', 'Kohl', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528098811', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00531', 'ELHT00531', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Christopher', 'V', 'Tehlirian', 'MD', 'Internal Medicine', '', '', NULL, 'O', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', '700 Walter Reed Blvd Ste 204', 'Garland', 'Dallas', 'TX', '75042', '9724875462', '9724875277', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528104270', 0, 'Y', 0, '2013-05-01', NULL, NULL, 32.9186, -96.6634, NULL, NULL),
('752536818', 'ELHT00532', 'ELHT00532', 'TXDALSTD', 'Inpatient Care Unit at Baylor Medical Center Garland', 'Christopher', 'V', 'Tehlirian', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528104270', 0, 'N', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00159', 'ELHT00159', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Armine', '', 'Tumyan', 'MD', 'Rheumatology', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1528280864', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00160', 'ELHT00160', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Armine', '', 'Tumyan', 'MD', 'Rheumatology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1528280864', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00533', 'ELHT00533', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Michael', 'P', 'Witt', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1538117643', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.8341, -96.9592, NULL, NULL),
('752536818', 'ELHT00534', 'ELHT00534', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Michael', 'P', 'Witt', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1538117643', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00959', 'ELHT00959', 'TXDALSTD', 'Southlake Family Medicine', 'Joyce', 'L', 'Stroud', 'DO', 'Family Practice', '', '', NULL, 'O', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1538175682', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.941, -97.1405, NULL, NULL),
('752536818', 'ELHT00960', 'ELHT00960', 'TXDALSTD', 'Southlake Family Medicine', 'Joyce', 'L', 'Stroud', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1538175682', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00961', 'ELHT00961', 'TXDALSTD', 'Baylor Family Medicine at Keller', 'Jason', 'F', 'Wander', 'DO', 'Family Practice', '', '', NULL, 'O', '601 S Main St Ste 200', 'Keller', 'Tarrant', 'TX', '76248', '8177536888', '8177536885', '601 S Main St Ste 200', 'Keller', 'Tarrant', 'TX', '76248', '8177536888', '8177536885', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Emergency Medical Center at Keller', NULL, '', NULL, 'HCFA|UB|', '1538367313', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.9271, -97.2541, NULL, NULL),
('752536818', 'ELHT00962', 'ELHT00962', 'TXDALSTD', 'Baylor Family Medicine at Keller', 'Jason', 'F', 'Wander', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Emergency Medical Center at Keller', NULL, '', NULL, 'HCFA|UB|', '1538367313', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00535', 'ELHT00535', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Lindsay', 'E', 'Boltan', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', '1901 N MacArthur Blvd', 'Irving', 'Dallas', 'TX', '75061', '9725798485', '9725793972', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538379433', 0, 'Y', 0, '2012-12-20', NULL, NULL, 32.8341, -96.9592, NULL, NULL),
('752536818', 'ELHT00536', 'ELHT00536', 'TXDALSTD', 'NTHCA Inpatient Care Unit', 'Lindsay', 'E', 'Boltan', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538379433', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00963', 'ELHT00963', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Sharon', 'E', 'Tucker', 'MD', 'Family Practice', '', '', NULL, 'O', '1575 I-30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', '1575 I 30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548219975', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8297, -96.6193, NULL, NULL),
('752536818', 'ELHT00964', 'ELHT00964', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Sharon', 'E', 'Tucker', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548219975', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00537', 'ELHT00537', 'TXDALSTD', 'Internal Medicine Associates at Irving', 'John', 'D', 'Young', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2021 N MacArthur Blvd Ste 520', 'Irving', 'Dallas', 'TX', '75061', '9722512388', '9722512390', '2021 N MacArthur Blvd Ste 520', 'Irving', 'Dallas', 'TX', '75061', '9722512388', '9722512390', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1548286610', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.835, -96.9592, NULL, NULL),
('752536818', 'ELHT00538', 'ELHT00538', 'TXDALSTD', 'Internal Medicine Associates at Irving', 'John', 'D', 'Young', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Irving', NULL, NULL, NULL, 'HCFA|UB|', '1548286610', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00965', 'ELHT00965', 'TXDALSTD', 'Health Texas Provider Network', 'Heather', 'A', 'Bass', 'MD', 'Family Practice', '', '', NULL, 'O', '5236 W University Dr Ste 1500', 'McKinney', 'Collin', 'TX', '75071', '4698005100', '4698005110', '5236 W University Dr Ste 1500', 'McKinney', 'Collin', 'TX', '75071', '4698005100', '4698005110', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, NULL, NULL, 'HCFA|UB|', '1548476526', 0, 'N', 0, '2013-06-07', NULL, NULL, 33.2183, -96.684, NULL, NULL),
('752536818', 'ELHT00966', 'ELHT00966', 'TXDALSTD', 'Health Texas Provider Network', 'Heather', 'A', 'Bass', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at McKinney', NULL, NULL, NULL, 'HCFA|UB|', '1548476526', 0, 'Y', 0, '2013-06-07', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00771', 'ELHT00771', 'TXDALSTD', 'Liver Consultants of Texas', 'Apurva', 'A', 'Modi', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1250 8th Ave Ste 515', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179224675', '8179224645', '1250 8th Ave Ste 515', 'Ft Worth', 'Tarrant', 'TX', '76104', '8179224675', '8179224645', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558300137', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.7312, -97.3437, NULL, NULL),
('752536818', 'ELHT00772', 'ELHT00772', 'TXDALSTD', 'Liver Consultants of Texas', 'Apurva', 'A', 'Modi', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558300137', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00123', 'ELHT00123', 'TXDALSTD', 'Baylor Specialty Associates of Fort Worth', 'Gonzalo', '', 'Lievano', 'MD', 'Urology', '', '', NULL, 'O', '1307 8th Ave Ste 306', 'Ft Worth', 'Tarrant', 'TX', '76104', '8279128040', '8179262911', '1307 8th Ave Ste 306', 'Ft Worth', 'Tarrant', 'TX', '76104', '8279128040', '8179262911', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-07-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558302976', 0, 'N', 0, '2013-07-23', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00124', 'ELHT00124', 'TXDALSTD', 'Baylor Specialty Associates of Fort Worth', 'Gonzalo', '', 'Lievano', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-07-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558302976', 0, 'N', 0, '2013-07-23', NULL, NULL, 0, 0, NULL, NULL),
('752600832', 'ELHT00539', 'ELHT00539', 'TXDALSTD', 'MedProvider', 'Randlow', '', 'Smith', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3434 Swiss Ave Ste 206', 'Dallas', 'Dallas', 'TX', '75204', '2148285660', '2148285659', '3434 Swiss Ave Ste 206', 'Dallas', 'Dallas', 'TX', '75204', '2148285660', '2148285659', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558474148', 0, 'N', 0, '2013-06-14', NULL, NULL, 32.7915, -96.7824, NULL, NULL),
('752582845', 'ELHT00329', 'ELHT00329', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Avesh', 'R', 'Verma', 'MD', 'Neurology', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1558563031', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00330', 'ELHT00330', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Avesh', 'R', 'Verma', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1558563031', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00967', 'ELHT00967', 'TXDALSTD', 'Baylor Family Medicine Southwest', 'Kimberly', 'T', 'Eden', 'MD', 'Family Practice', '', '', NULL, 'O', '5701 Bryant Irvin Rd Ste 301', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173616200', '8173616201', '5701 Bryant Irvin Rd Ste 301', 'Ft Worth', 'Tarrant', 'TX', '76132', '8173616200', '8173616201', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', NULL, 'HCFA|UB|', '1568411684', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.6664, -97.4199, NULL, NULL),
('752536818', 'ELHT00968', 'ELHT00968', 'TXDALSTD', 'Baylor Family Medicine Southwest', 'Kimberly', 'T', 'Eden', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor All Saints Medical Center', NULL, '', NULL, 'HCFA|UB|', '1568411684', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00969', 'ELHT00969', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Lance', 'J', 'Miller', 'DO', 'Family Practice', '', '', NULL, 'O', '1575 I-30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', '1575 I 30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568411999', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.8297, -96.6193, NULL, NULL),
('752536818', 'ELHT00970', 'ELHT00970', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Lance', 'J', 'Miller', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568411999', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'ELHT00541', 'ELHT00541', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Danielle', 'R', 'Ford', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568601516', 0, 'N', 0, '2013-09-16', NULL, NULL, 32.79, -96.7806, NULL, NULL),
('911947573', 'ELHT00542', 'ELHT00542', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Danielle', 'R', 'Ford', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-08-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568601516', 0, 'N', 0, '2013-09-16', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00971', 'ELHT00971', 'TXDALSTD', 'Baylor Family Medicine at Wylie', 'Travis', 'M', 'Caudill', 'MD', 'Family Practice', '', '', NULL, 'O', '600 Cooper Dr Ste 100', 'Wylie', 'Collin', 'TX', '75098', '9724427325', '9724428348', '600 Cooper Dr Ste 100', 'Wylie', 'Collin', 'TX', '75098', '9724427325', '9724428348', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1578512059', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0092, -96.5443, NULL, NULL),
('752536818', 'ELHT00972', 'ELHT00972', 'TXDALSTD', 'Baylor Family Medicine at Wylie', 'Travis', 'M', 'Caudill', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1578512059', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00973', 'ELHT00973', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Laura', 'L', 'Frye', 'MD', 'Family Practice', '', '', NULL, 'O', '1575 I-30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', '1575 I-30', 'Mesquite', 'Dallas', 'TX', '75150', '4698002800', '4698002801', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2014-01-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578512679', 0, 'N', 0, '2014-02-24', NULL, NULL, 32.8339, -96.6106, NULL, NULL),
('752536818', 'ELHT00974', 'ELHT00974', 'TXDALSTD', 'Baylor Family Health Center at Mesquite', 'Laura', 'L', 'Frye', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2014-01-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578512679', 0, 'Y', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00543', 'ELHT00543', 'TXDALSTD', 'Dallas Diagnostic Association Garland', 'Krishnan', '', 'Nair', 'MD', 'Internal Medicine', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 300', 'Garland', 'Dallas', 'TX', '75042', '4698002000', '9722722073', '601 Clara Barton Blvd Ste 300', 'Garland', 'Dallas', 'TX', '75042', '4698002000', '9722722073', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1578518684', 0, 'N', 0, '2013-09-16', NULL, NULL, 32.9175, -96.662, NULL, NULL),
('752536818', 'ELHT00544', 'ELHT00544', 'TXDALSTD', 'Dallas Diagnostic Association Garland', 'Krishnan', '', 'Nair', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Garland', NULL, NULL, NULL, 'HCFA|UB|', '1578518684', 0, 'N', 0, '2013-09-16', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00975', 'ELHT00975', 'TXDALSTD', 'Baylor Family Medicine at Garland', 'Shobha', 'S', 'Rao', 'MD', 'Family Practice', '', '', NULL, 'O', '601 Clara Barton Blvd Ste 340', 'Garland', 'Dallas', 'TX', '75042', '9722726554', '9722729137', '601 Clara Barton Blvd Ste 340', 'Garland', 'Dallas', 'TX', '75042', '9722726554', '9722729137', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-02-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578523486', 0, 'N', 0, '2013-05-15', NULL, NULL, 32.9184, -96.6636, NULL, NULL),
('752536818', 'ELHT00976', 'ELHT00976', 'TXDALSTD', 'Baylor Family Medicine at Garland', 'Shobha', 'S', 'Rao', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', '2013-02-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1578523486', 0, 'Y', 0, '2013-05-15', NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'ELHT00133', 'ELHT00133', 'TXDALSTD', 'Cardiac Surgery at Baylor University Medical Center at Dallas', 'Gonzalo', 'V', 'Gonzalez Stawinski', 'MD', 'Thoracic Surgery', '', '', NULL, 'O', '3900 Junius St Ste 605', 'Dallas', 'Dallas', 'TX', '75246', '2148207100', '2148206863', '3900 Junius St Ste 605', 'Dallas', 'Dallas', 'TX', '75246', '2148207100', '2148206863', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1578572186', 0, 'N', 0, '2012-12-20', NULL, NULL, 32.791, -96.7782, NULL, NULL),
('752536818', 'ELHT00134', 'ELHT00134', 'TXDALSTD', 'Cardiac Surgery at Baylor University Medical Center at Dallas', 'Gonzalo', 'V', 'Gonzalez Stawinski', 'MD', 'Thoracic Surgery', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1578572186', 0, 'N', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00773', 'ELHT00773', 'TXDALSTD', '', 'Paul', 'K', 'Anderson', 'MD', 'Gastroenterology', '', '', NULL, 'O', '4708 Alliance Blvd Ste 200', 'Plano', 'Collin', 'TX', '75093', '4698006020', '4698006001', '4708 Alliance Blvd Ste 200', 'Plano', 'Collin', 'TX', '75093', '4698006020', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1578676664', 0, 'N', 0, '2014-01-30', NULL, NULL, 33.0145, -96.7925, NULL, NULL),
('752582845', 'ELHT00774', 'ELHT00774', 'TXDALSTD', '', 'Paul', 'K', 'Anderson', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, NULL, NULL, 'HCFA|UB|', '1578676664', 0, 'Y', 0, '2014-01-30', NULL, NULL, 0, 0, NULL, NULL),
('752582845', 'ELHT00545', 'ELHT00545', 'TXDALSTD', 'Dallas Diagnostic Association Plano', 'Adrian', 'H', 'Nguyen', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', '4708 Alliance Blvd Baylor Med Pl 1', 'Plano', 'Collin', 'TX', '75093', '4698006000', '4698006001', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Plano', NULL, '', NULL, 'HCFA|UB|', '1578698080', 0, 'N', 0, '2012-12-20', NULL, NULL, 33.0145, -96.7925, NULL, NULL);
