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
('742938437', 'TX0100331', 'TX0100331', 'TXSATSTD', 'MacGregor Medical Center', 'Fernando', '', 'Aguirre', 'MD', 'Internal Medicine', '', '', NULL, 'O', '9969 Fredericksburg Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106902273', NULL, '9969 Fredericksburg Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106902273', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861499444', 0, 'N', 0, '2013-04-09', NULL, NULL, 29.5362, -98.5776, NULL, NULL),
('742938437', 'TX0100332', 'TX0100332', 'TXSATSTD', 'MacGregor Medical Center', 'Brian', 'P', 'Senger', 'MD', 'Internal Medicine', '', '', NULL, 'O', '9969 Fredericksburg Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106902273', NULL, '9969 Fredericksburg Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106902273', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194722660', 0, 'N', 0, '2013-04-09', NULL, NULL, 29.5362, -98.5776, NULL, NULL),
('742938437', 'TX0100334', 'TX0100334', 'TXSATSTD', 'MacGregor Medical Center', 'Ana', 'I', 'Rodriguez', 'MD', 'Internal Medicine', '', '', NULL, 'O', '9969 Fredericksburg Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106902273', NULL, '9969 Fredericksburg Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106902273', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1871599449', 0, 'N', 0, '2013-04-09', NULL, NULL, 29.5362, -98.5776, NULL, NULL),
('742938437', 'TX0100336', 'TX0100336', 'TXSATSTD', 'MacGregor Medical Center', 'Dennis', 'C', 'Oliver', 'MD', 'Internal Medicine', '', '', NULL, 'O', '9969 Fredericksburg Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106902273', NULL, '9969 Fredericksburg Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106902273', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265439541', 0, 'N', 0, '2013-04-09', NULL, NULL, 29.5362, -98.5776, NULL, NULL),
('202148889', 'TX0100338', 'TX0100338', 'TXSATSTD', 'Health Texas Medical Group of San Antonio', '', '', 'Health Texas Medical Group of San Antonio', 'GROUP', 'Internal Medicine', '', '', NULL, 'O', '2911 S New Braunfels', 'San Antonio', 'Bexar', 'TX', '78210', '2105320891', NULL, '2911 S New Braunfels', 'San Antonio', 'Bexar', 'TX', '78210', '2105320891', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006634', 0, 'Y', 0, '2013-06-04', NULL, NULL, 29.3904, -98.4612, NULL, NULL),
('202148889', 'TX0100339', 'TX0100339', 'TXSATSTD', 'Health Texas Medical Group of San Antonio', '', '', 'Health Texas Medical Group of San Antonio', 'GROUP', 'Internal Medicine', '', '', NULL, 'O', '215 E Quincy Ste 500', 'San Antonio', 'Bexar', 'TX', '78215', '2102231600', NULL, '215 E Quincy Ste 500', 'San Antonio', 'Bexar', 'TX', '78215', '2102231600', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006634', 0, 'Y', 0, '2013-06-04', NULL, NULL, 29.4354, -98.493, NULL, NULL),
('202148889', 'TX0100340', 'TX0100340', 'TXSATSTD', 'Health Texas Medical Group of San Antonio', '', '', 'Health Texas Medical Group of San Antonio', 'GROUP', 'Internal Medicine', '', '', NULL, 'O', '810 SE Military Dr', 'San Antonio', 'Bexar', 'TX', '78214', '2109214200', NULL, '810 SE Military Dr', 'San Antonio', 'Bexar', 'TX', '78214', '2109214200', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006634', 0, 'Y', 0, '2013-06-04', NULL, NULL, 29.3567, -98.4881, NULL, NULL),
('202148889', 'TX0100341', 'TX0100341', 'TXSATSTD', 'Health Texas Medical Group of San Antonio', '', '', 'Health Texas Medical Group of San Antonio', 'GROUP', 'Internal Medicine', '', '', NULL, 'O', '803 Castroville Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78237', '2104367402', NULL, '803 Castroville Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78237', '2104367402', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006634', 0, 'Y', 0, '2013-06-04', NULL, NULL, 29.4169, -98.5526, NULL, NULL),
('202148889', 'TX0100342', 'TX0100342', 'TXSATSTD', 'Health Texas Medical Group of San Antonio', '', '', 'Health Texas Medical Group of San Antonio', 'GROUP', 'Internal Medicine', '', '', NULL, 'O', '8542 Wurzbach Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106167300', NULL, '8542 Wurzbach Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106167300', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006634', 0, 'Y', 0, '2013-06-04', NULL, NULL, 29.5207, -98.5727, NULL, NULL),
('202148889', 'TX0100343', 'TX0100343', 'TXSATSTD', 'Health Texas Medical Group of San Antonio', '', '', 'Health Texas Medical Group of San Antonio', 'GROUP', 'Internal Medicine', '', '', NULL, 'O', '6428 Bandera Rd', 'San Antonio', 'Bexar', 'TX', '78238', '2105204455', NULL, '6428 Bandera Rd', 'San Antonio', 'Bexar', 'TX', '78238', '2105204455', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006634', 0, 'Y', 0, '2013-06-04', NULL, NULL, 29.49, -98.6115, NULL, NULL),
('202148889', 'TX0100344', 'TX0100344', 'TXSATSTD', 'Health Texas Medical Group of San Antonio', '', '', 'Health Texas Medical Group of San Antonio', 'GROUP', 'Internal Medicine', '', '', NULL, 'O', '1200 Brooklyn Ave Ste 240', 'San Antonio', 'Bexar', 'TX', '78212', '2102254511', NULL, '1200 Brooklyn Ave Ste 240', 'San Antonio', 'Bexar', 'TX', '78212', '2102254511', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006634', 0, 'Y', 0, '2013-06-04', NULL, NULL, 29.4395, -98.4904, NULL, NULL),
('202148889', 'TX0100345', 'TX0100345', 'TXSATSTD', 'Health Texas Medical Group of San Antonio', '', '', 'Health Texas Medical Group of San Antonio', 'GROUP', 'Internal Medicine', '', '', NULL, 'O', '624 W Sunset Blvd', 'San Antonio', 'Bexar', 'TX', '78216', '2108282531', NULL, '624 W Sunset Blvd', 'San Antonio', 'Bexar', 'TX', '78216', '2108282531', '', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006634', 0, 'Y', 0, '2013-06-04', NULL, NULL, 29.5079, -98.4797, NULL, NULL),
('742743906', 'TX0100394', 'TX0100394', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Carl', 'J', 'Blond', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174507776', 0, 'y', 0, '2013-04-24', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100395', 'TX0100395', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Wesley', 'B', 'Calhoun', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1174508659', 0, 'y', 0, '2012-08-20', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100396', 'TX0100396', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Gerardo', 'A', 'Chica', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1790760940', 0, 'y', 0, '2013-02-06', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100397', 'TX0100397', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Larry', 'R', 'Davis', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1386628998', 0, 'y', 0, '2013-07-03', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100398', 'TX0100398', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Susan', 'A', 'Diamond', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1508840125', 0, 'y', 0, '2012-08-20', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100399', 'TX0100399', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Alfredo', '', 'Fiallo', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417931031', 0, 'y', 0, '2012-08-20', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100401', 'TX0100401', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Terrance', 'A', 'Fried', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1154305787', 0, 'y', 0, '2013-05-06', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100402', 'TX0100402', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Rodolfo', 'O', 'Garza', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1184609349', 0, 'y', 0, '2013-06-05', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100403', 'TX0100403', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Christopher', 'W', 'Glanton', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1609840222', 0, 'y', 0, '2012-08-20', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100404', 'TX0100404', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Steven', 'F', 'Gouge', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1396729927', 0, 'y', 0, '2013-04-24', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100405', 'TX0100405', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Claudia', 'E', 'Hura', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023092657', 0, 'N', 0, '2013-08-05', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100406', 'TX0100406', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Lin', 'Z', 'Johnson', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1104801737', 0, 'y', 0, '2013-05-02', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100407', 'TX0100407', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'John', 'E', 'Kobert', 'DO', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376528810', 0, 'y', 0, '2013-05-07', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100408', 'TX0100408', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Rahul', '', 'Koushik', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275518755', 0, 'y', 0, '2013-04-24', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100410', 'TX0100410', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Elzbieta', 'B', 'McMurtrie', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1891770343', 0, 'y', 0, '2013-05-06', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100411', 'TX0100411', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Caridad', 'M', 'Rebollar', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1073598520', 0, 'y', 0, '2013-04-24', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100412', 'TX0100412', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'H', 'John', 'Reineck', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407831969', 0, 'N', 0, '2013-02-04', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100413', 'TX0100413', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Steven', 'G', 'Rosenblatt', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1710962279', 0, 'y', 0, '2013-05-06', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100414', 'TX0100414', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Peter', '', 'Smolens', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1447235908', 0, 'y', 0, '2012-08-20', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100415', 'TX0100415', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'William', 'G', 'Wortham', 'MD', 'Nephrology', '', '', NULL, 'B', '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', NULL, '7142 San Pedro Ave Ste 120', 'San Antonio', 'Bexar', 'TX', '78216', '2106615622', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-02-01', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1407831449', 0, 'N', 0, '2013-02-04', NULL, NULL, 29.5128, -98.4973, NULL, NULL),
('742743906', 'TX0100417', 'TX0100417', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Peter', '', 'Smolens', 'MD', 'Nephrology', '', '', NULL, 'O', '2391 NE Loop 410 Ste 405', 'San Antonio', 'Bexar', 'TX', '78217', '2106547326', NULL, '2391 NE Loop 410 Ste 405', 'San Antonio', 'Bexar', 'TX', '78217', '2106547326', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1447235908', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.5163, -98.4204, NULL, NULL),
('742743906', 'TX0100418', 'TX0100418', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'William', 'G', 'Wortham', 'MD', 'Nephrology', '', '', NULL, 'O', '2391 NE Loop 410 Ste 405', 'San Antonio', 'Bexar', 'TX', '78217', '2106547326', NULL, '2391 NE Loop 410 Ste 405', 'San Antonio', 'Bexar', 'TX', '78217', '2106547326', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-02-01', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1407831449', 0, 'N', 0, '2013-02-04', NULL, NULL, 29.5177, -98.4195, NULL, NULL),
('742743906', 'TX0100419', 'TX0100419', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Carl', 'J', 'Blond', 'MD', 'Nephrology', '', '', NULL, 'O', '2391 NE Loop 410 Ste 405', 'San Antonio', 'Bexar', 'TX', '78217', '2106547326', NULL, '2391 NE Loop 410 Ste 405', 'San Antonio', 'Bexar', 'TX', '78217', '2106547326', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174507776', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.5163, -98.4204, NULL, NULL),
('742743906', 'TX0100420', 'TX0100420', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Steven', 'F', 'Gouge', 'MD', 'Nephrology', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', NULL, '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1396729927', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.5151, -98.5765, NULL, NULL),
('742743906', 'TX0100421', 'TX0100421', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Rahul', '', 'Koushik', 'MD', 'Nephrology', '', '', NULL, 'O', '2391 NE Loop 410 Ste 405', 'San Antonio', 'Bexar', 'TX', '78217', '2106547326', NULL, '2391 NE Loop 410 Ste 405', 'San Antonio', 'Bexar', 'TX', '78217', '2106547326', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275518755', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.5163, -98.4204, NULL, NULL),
('742743906', 'TX0100422', 'TX0100422', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Rodolfo', 'O', 'Garza', 'MD', 'Nephrology', '', '', NULL, 'O', '116 Gallery Cir Ste 202', 'San Antonio', 'Bexar', 'TX', '78258', '2104958280', NULL, '116 Gallery Cir Ste 202', 'San Antonio', 'Bexar', 'TX', '78258', '2104958280', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-01-31', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1184609349', 0, 'N', 0, '2013-06-05', NULL, NULL, 0, 0, NULL, NULL),
('742743906', 'TX0100423', 'TX0100423', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Christopher', 'W', 'Glanton', 'MD', 'Nephrology', '', '', NULL, 'O', '116 Gallery Cir Ste 202', 'San Antonio', 'Bexar', 'TX', '78258', '2104958280', NULL, '116 Gallery Cir Ste 202', 'San Antonio', 'Bexar', 'TX', '78258', '2104958280', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-01-31', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1609840222', 0, 'N', 0, '2013-02-04', NULL, NULL, 0, 0, NULL, NULL),
('742743906', 'TX0100424', 'TX0100424', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Caridad', 'M', 'Rebollar', 'MD', 'Nephrology', '', '', NULL, 'O', '4242 E Southcross Blvd Ste 4', 'San Antonio', 'Bexar', 'TX', '78222', '2103374911', NULL, '4242 E Southcross Blvd Ste 4', 'San Antonio', 'Bexar', 'TX', '78222', '2103374911', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-01-31', 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1073598520', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.374, -98.4109, NULL, NULL),
('742743906', 'TX0100425', 'TX0100425', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Elzbieta', 'B', 'McMurtrie', 'MD', 'Nephrology', '', '', NULL, 'O', '4242 E Southcross Blvd Ste 4', 'San Antonio', 'Bexar', 'TX', '78222', '2103374911', NULL, '4242 E Southcross Blvd Ste 4', 'San Antonio', 'Bexar', 'TX', '78222', '2103374911', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1891770343', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.3749, -98.4113, NULL, NULL),
('742743906', 'TX0100426', 'TX0100426', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Alfredo', '', 'Fiallo', 'MD', 'Nephrology', '', '', NULL, 'O', '1008 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', NULL, '1008 Brooklyn', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417931031', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.4377, -98.4891, NULL, NULL),
('742743906', 'TX0100427', 'TX0100427', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Terrance', 'A', 'Fried', 'MD', 'Nephrology', '', '', NULL, 'O', '1008 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', NULL, '1008 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1154305787', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.4377, -98.4891, NULL, NULL),
('742743906', 'TX0100428', 'TX0100428', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Elzbieta', 'B', 'McMurtrie', 'MD', 'Nephrology', '', '', NULL, 'O', '1008 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', NULL, '1008 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1891770343', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.4377, -98.4891, NULL, NULL),
('742743906', 'TX0100429', 'TX0100429', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Larry', 'R', 'Davis', 'MD', 'Nephrology', '', '', NULL, 'O', '409 Madrid', 'Castroville', 'Medina', 'TX', '78009', '2106927228', NULL, '409 Madrid', 'Castroville', 'Medina', 'TX', '78009', '2106927228', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1386628998', 0, 'Y', 0, '2013-07-03', NULL, NULL, 29.3579, -98.8782, NULL, NULL),
('742743906', 'TX0100430', 'TX0100430', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Lin', 'Z', 'Johnson', 'MD', 'Nephrology', '', '', NULL, 'O', '1528 E Commons St Ste 1', 'New Braunfels', 'Comal', 'TX', '78130', '8306204650', NULL, '1528 E Commons St Ste 1', 'New Braunfels', 'Comal', 'TX', '78130', '8306204650', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1104801737', 0, 'N', 0, '2013-05-02', NULL, NULL, 29.7243, -98.0974, NULL, NULL),
('742743906', 'TX0100431', 'TX0100431', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Gerardo', 'A', 'Chica', 'MD', 'Nephrology', '', '', NULL, 'O', '222 Sidney Baker S Ste 208', 'Kerrville', 'Kerr', 'TX', '78028', '8308967607', NULL, '222 Sidney Baker S Ste 208', 'Kerrville', 'Kerr', 'TX', '78028', '8308967607', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1790760940', 0, 'Y', 0, '2013-02-06', NULL, NULL, 30.0436, -99.1449, NULL, NULL),
('742743906', 'TX0100432', 'TX0100432', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Larry', 'R', 'Davis', 'MD', 'Nephrology', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', NULL, '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1386628998', 0, 'N', 0, '2013-07-03', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742743906', 'TX0100433', 'TX0100433', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Susan', 'A', 'Diamond', 'MD', 'Nephrology', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', NULL, '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1508840125', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742743906', 'TX0100434', 'TX0100434', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Claudia', 'E', 'Hura', 'MD', 'Nephrology', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', NULL, '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023092657', 0, 'N', 0, '2013-08-05', NULL, NULL, 29.5151, -98.5765, NULL, NULL),
('742743906', 'TX0100435', 'TX0100435', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'H', 'John', 'Reineck', 'MD', 'Nephrology', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', NULL, '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-02-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407831969', 0, 'N', 0, '2013-02-04', NULL, NULL, 29.5151, -98.5765, NULL, NULL),
('742743906', 'TX0100436', 'TX0100436', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Steven', 'G', 'Rosenblatt', 'MD', 'Nephrology', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', NULL, '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1710962279', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742743906', 'TX0100437', 'TX0100437', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Wesley', 'B', 'Calhoun', 'MD', 'Nephrology', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', NULL, '8042 Wurzbach Rd Ste 500', 'San Antonio', 'Bexar', 'TX', '78229', '2106927228', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1174508659', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742743906', 'TX0100438', 'TX0100438', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'John', 'E', 'Kobert', 'DO', 'Nephrology', '', '', NULL, 'O', '559 10th St Ste 1', 'Floresville', 'Wilson', 'TX', '78114', '8302162606', '          ', '559 10th St Ste 1', 'Floresville', 'Wilson', 'TX', '78114', '8302162606', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-04-06', 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376528810', 0, 'N', 0, '2014-04-10', NULL, NULL, 29.153, -98.1661, NULL, NULL),
('742743906', 'TX0100439', 'TX0100439', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Elzbieta', 'B', 'McMurtrie', 'MD', 'Nephrology', '', '', NULL, 'O', '1301 Hospital Blvd', 'Floresville', 'Wilson', 'TX', '78114', '8302162606', NULL, '1301 Hospital Blvd', 'Floresville', 'Wilson', 'TX', '78114', '8302162606', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-05', 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1891770343', 0, 'N', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('742743906', 'TX0100440', 'TX0100440', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Gerardo', 'A', 'Chica', 'MD', 'Nephrology', '', '', NULL, 'O', '402 W Windcrest', 'Fredericksburg', 'Gillespie', 'TX', '78624', '8309973134', NULL, '402 W Windcrest', 'Fredericksburg', 'Gillespie', 'TX', '78624', '8309973134', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-10-01', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1790760940', 0, 'Y', 0, '2013-02-06', NULL, NULL, 0, 0, NULL, NULL),
('742743906', 'TX0100441', 'TX0100441', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Christopher', 'W', 'Glanton', 'MD', 'Nephrology', '', '', NULL, 'O', '1201 S Main St Ste 118', 'Boerne', 'Kendall', 'TX', '78006', '2104958280', NULL, '1201 S Main St Ste 118', 'Boerne', 'Kendall', 'TX', '78006', '2104958280', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1609840222', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.7783, -98.7278, NULL, NULL),
('742743906', 'TX0100442', 'TX0100442', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Rodolfo', 'O', 'Garza', 'MD', 'Nephrology', '', '', NULL, 'O', '32665 Hwy 281 N Ste 206', 'Bulverde', 'Comal', 'TX', '78163', '2104958280', NULL, '32665 Hwy 281 N Ste 206', 'Bulverde', 'Comal', 'TX', '78163', '2104958280', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1184609349', 0, 'N', 0, '2013-06-05', NULL, NULL, 29.7791, -98.4253, NULL, NULL),
('742743906', 'TX0100443', 'TX0100443', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Steven', 'F', 'Gouge', 'MD', 'Nephrology', '', '', NULL, 'O', '12315 Judson Rd Ste 304', 'Live Oak', 'Bexar', 'TX', '78233', '2105908232', NULL, '12315 Judson Rd Ste 304', 'Live Oak', 'Bexar', 'TX', '78233', '2105908232', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1396729927', 0, 'N', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742743906', 'TX0100444', 'TX0100444', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'John', 'E', 'Kobert', 'DO', 'Nephrology', '', '', NULL, 'O', '3349 S Hwy 181', 'Kenedy', 'Karnes', 'TX', '78119', '8302162606', NULL, '3349 S Hwy 181', 'Kenedy', 'Karnes', 'TX', '78119', '8302162606', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376528810', 0, 'N', 0, '2013-05-07', NULL, NULL, 28.7952, -97.8507, NULL, NULL),
('200743330', 'TX0100448', 'TX0100448', 'TXSATSTD', 'Mohammad R Mizani MD', 'Mohammad', 'R', 'Mizani', 'MD', 'Nephrology', '', '', NULL, 'O', '343 W Houston St Ste 609', 'San Antonio', 'Bexar', 'TX', '78205', '2102128622', NULL, '343 W Houston St Ste 609', 'San Antonio', 'Bexar', 'TX', '78205', '2102128622', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1497757660', 0, 'N', 0, '2013-07-08', NULL, NULL, 29.4264, -98.4967, NULL, NULL),
('200743330', 'TX0100449', 'TX0100449', 'TXSATSTD', 'Mohammad R Mizani MD', 'Mohammad', 'R', 'Mizani', 'MD', 'Nephrology', '', '', NULL, 'B', 'PO Box 504152', 'St Louis', 'Saint Louis City', 'MO', '63150', '2103231200', NULL, 'PO Box 504152', 'St Louis', 'Saint Louis City', 'MO', '63150', '2103231200', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1497757660', 0, 'N', 0, '2013-07-08', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'TX0100470', 'TX0100470', 'TXSATSTD', 'Renal Associates', 'Robert', 'E', 'Stevens', 'MD', 'Nephrology', '', '', NULL, 'O', '7434 Louis Pasteur Dr Ste 309', 'San Antonio', 'Bexar', 'TX', '78229', '2106141231', NULL, '7434 Louis Pasteur Dr Ste 309', 'San Antonio', 'Bexar', 'TX', '78229', '2106141231', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528035185', 0, 'N', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'TX0100471', 'TX0100471', 'TXSATSTD', 'Renal Associates', 'Timoteo', '', 'Cabrera', 'MD', 'Nephrology', '', '', NULL, 'O', '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', NULL, '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-05', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144295064', 0, 'N', 0, '2013-07-03', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'TX0100472', 'TX0100472', 'TXSATSTD', 'Renal Associates', 'Cleve', 'B', 'Collins', 'MD', 'Nephrology', '', '', NULL, 'O', '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', NULL, '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-05', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1730154667', 0, 'N', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'TX0100473', 'TX0100473', 'TXSATSTD', 'Renal Associates', 'Michael', 'V', 'DeGaetano', 'DO', 'Internal Medicine', '', '', NULL, 'O', '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', NULL, '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-05', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1881660454', 0, 'N', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'TX0100474', 'TX0100474', 'TXSATSTD', 'Renal Associates', 'Melissa', 'R', 'Isbell', 'MD', 'Nephrology', '', '', NULL, 'O', '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', NULL, '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-05', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1881660660', 0, 'N', 0, '2013-07-29', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'TX0100475', 'TX0100475', 'TXSATSTD', 'Renal Associates', 'Paraic', 'J', 'Mulgrew', 'MD', 'Nephrology', '', '', NULL, 'O', '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', NULL, '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-05', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1730155755', 0, 'N', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('742083988', 'TX0100476', 'TX0100476', 'TXSATSTD', 'Renal Associates', 'Christine', 'M', 'Toth', 'MD', 'Nephrology', '', '', NULL, 'O', '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', NULL, '7434 Louis Pasteur Dr Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106141515', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1851367668', 0, 'N', 0, '2013-04-05', NULL, NULL, 0, 0, NULL, NULL),
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('742083988', 'TX0100499', 'TX0100499', 'TXSATSTD', 'Renal Associates', 'Ronald', 'W', 'Hamner', 'MD', 'Nephrology', '', '', NULL, 'O', '1603 Hwy 97 E', 'Jourdanton', 'Atascosa', 'TX', '78026', '8307694125', NULL, '1603 Hwy 97 E', 'Jourdanton', 'Atascosa', 'TX', '78026', '8307694125', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1467427401', 0, 'N', 0, '2013-09-24', NULL, NULL, 28.9262, -98.5338, NULL, NULL),
('742083988', 'TX0100500', 'TX0100500', 'TXSATSTD', 'Renal Associates', 'Christine', 'M', 'Toth', 'MD', 'Nephrology', '', '', NULL, 'O', '2201 N Bedell Ste D', 'Del Rio', 'Val Verde', 'TX', '78840', '8307757840', NULL, '2201 N Bedell Ste D', 'Del Rio', 'Val Verde', 'TX', '78840', '8307757840', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1851367668', 0, 'Y', 0, '2013-04-05', NULL, NULL, 29.3886, -100.902, NULL, NULL);
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('742083988', 'TX0100503', 'TX0100503', 'TXSATSTD', 'Renal Associates', '', '', 'Renal Associates PA', 'GROUP', 'Nephrology', '', '', NULL, 'O', '3103 Megan St', 'Eagle Pass', 'Maverick', 'TX', '78852', '8307730212', NULL, '3103 Megan St', 'Eagle Pass', 'Maverick', 'TX', '78852', '8307730212', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008357', 0, 'Y', 0, '2013-05-06', NULL, NULL, 28.7561, -100.49, NULL, NULL),
('742083988', 'TX0100504', 'TX0100504', 'TXSATSTD', 'Renal Associates', '', '', 'Renal Associates PA', 'GROUP', 'Nephrology', '', '', NULL, 'O', '19016 Stone Oak Pkwy Ste 210', 'San Antonio', 'Bexar', 'TX', '78258', '2104811818', NULL, '19016 Stone Oak Pkwy Ste 210', 'San Antonio', 'Bexar', 'TX', '78258', '2104811818', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008357', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.6182, -98.4941, NULL, NULL),
('742083988', 'TX0100505', 'TX0100505', 'TXSATSTD', 'Renal Associates', '', '', 'Renal Associates PA', 'GROUP', 'Nephrology', '', '', NULL, 'O', '4242 E Southcross Blvd Ste 16', 'San Antonio', 'Bexar', 'TX', '78258', '2103597888', NULL, '4242 E Southcross Blvd Ste 16', 'San Antonio', 'Bexar', 'TX', '78258', '2103597888', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008357', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.3749, -98.4113, NULL, NULL),
('742083988', 'TX0100506', 'TX0100506', 'TXSATSTD', 'Renal Associates', '', '', 'Renal Associates PA', 'GROUP', 'Nephrology', '', '', NULL, 'O', '1561 IH 35 N', 'New Braunfels', 'Comal', 'TX', '78130', '8306067323', NULL, '1561 IH 35 N', 'New Braunfels', 'Comal', 'TX', '78130', '8306067323', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008357', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.6983, -98.0827, NULL, NULL),
('742083988', 'TX0100507', 'TX0100507', 'TXSATSTD', 'Renal Associates', '', '', 'Renal Associates PA', 'GROUP', 'Nephrology', '', '', NULL, 'O', '497 10th St Ste 102', 'Floresville', 'Wilson', 'TX', '78114', '8303931750', NULL, '497 10th St Ste 102', 'Floresville', 'Wilson', 'TX', '78114', '8303931750', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008357', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.1586, -98.1724, NULL, NULL),
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('742083988', 'TX0100509', 'TX0100509', 'TXSATSTD', 'Renal Associates', '', '', 'Renal Associates PA', 'GROUP', 'Nephrology', '', '', NULL, 'O', '1603 Hwy 97 E', 'Jourdanton', 'Atascosa', 'TX', '78026', '8307694125', NULL, '1603 Hwy 97 E', 'Jourdanton', 'Atascosa', 'TX', '78026', '8307694125', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008357', 0, 'Y', 0, '2013-05-06', NULL, NULL, 28.9262, -98.5338, NULL, NULL),
('742083988', 'TX0100510', 'TX0100510', 'TXSATSTD', 'Renal Associates', '', '', 'Renal Associates PA', 'GROUP', 'Nephrology', '', '', NULL, 'O', '2201 N Bedell Ste D', 'Del Rio', 'Val Verde', 'TX', '78840', '8307757840', NULL, '2201 N Bedell Ste D', 'Del Rio', 'Val Verde', 'TX', '78840', '8307757840', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008357', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.3886, -100.902, NULL, NULL),
('741654878', 'TX0100511', 'TX0100511', 'TXSATSTD', 'Neurosurgical Associates of San Antonio', '', '', 'Neurosurgical Associates of San Antonio PA', '', 'Neurosurgery', '', '', NULL, 'O', '4410 Medical Dr Ste 610', 'San Antonio', 'Bexar', 'TX', '78229', '2106142453', '2106142462', '4410 Medical Dr Ste 610', 'San Antonio', 'Bexar', 'TX', '78229', '2106142453', '2106142462', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007825', 0, 'Y', 0, '2014-01-28', NULL, NULL, 29.5102, -98.5717, NULL, NULL),
('741654878', 'TX0100512', 'TX0100512', 'TXSATSTD', 'Neurosurgical Associates of San Antonio', '', '', 'Neurosurgical Associates of San Antonio PA', '', 'Neurosurgery', '', '', NULL, 'O', '18626 Hardy Oak Blvd Ste 240', 'San Antonio', 'Bexar', 'TX', '78258', '2104771956', NULL, '18626 Hardy Oak Blvd Ste 240', 'San Antonio', 'Bexar', 'TX', '78258', '2104771956', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-01-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007825', 0, 'Y', 0, '2014-01-28', NULL, NULL, 29.6141, -98.4776, NULL, NULL),
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('743003947', 'TX0100664', 'TX0100664', 'TXSATSTD', 'The San Antonio Orthopaedic Group', '', '', 'The San Antonio Orthopedic Group LLP', 'GROUP', 'Orthopedic Surgery', 'Physical Therapy', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009051', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100665', 'TX0100665', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Marvin', 'R', 'Brown', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1922040971', 0, 'Y', 0, '2013-11-05', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100666', 'TX0100666', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Stephen', 'S', 'Burkhart', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366487498', 0, 'Y', 0, '2013-04-09', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100668', 'TX0100668', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Ronald', 'W', 'Connor', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811939820', 0, 'Y', 0, '2013-07-10', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100670', 'TX0100670', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Stephen', 'C', 'Drukker', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1699717587', 0, 'Y', 0, '2013-08-22', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100672', 'TX0100672', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Mayo', 'J', 'Galindo', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-12-30', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1649212648', 0, 'Y', 0, '2014-01-28', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100673', 'TX0100673', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Francisco', 'J', 'Garcia', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003858978', 0, 'Y', 0, '2014-02-03', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100674', 'TX0100674', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'David', 'M', 'Gonzalez', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326080219', 0, 'Y', 0, '2013-10-15', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100676', 'TX0100676', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Alan', 'E', 'Hibberd', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093752909', 0, 'Y', 0, '2013-06-27', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100677', 'TX0100677', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Philip', 'M', 'Jacobs', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1033150602', 0, 'Y', 0, '2013-08-22', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100681', 'TX0100681', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Paul', 'D', 'Pace', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366483414', 0, 'Y', 0, '2013-08-22', 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
('743003947', 'TX0100682', 'TX0100682', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Alexander', 'S', 'Rowland', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1912948993', 0, 'Y', 0, '2013-12-10', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100683', 'TX0100683', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Brad', 'S', 'Tolin', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1124062385', 0, 'Y', 0, '2013-07-09', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100684', 'TX0100684', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Daniel', 'C', 'Valdez', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1902848823', 0, 'Y', 0, '2013-07-10', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100686', 'TX0100686', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Sergio', '', 'Viroslav', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1760424790', 0, 'Y', 0, '2013-05-31', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100688', 'TX0100688', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Marvin', 'R', 'Brown', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2105931400', NULL, '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2105931400', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1922040971', 0, 'N', 0, '2013-11-05', NULL, NULL, 29.5058, -98.4803, NULL, NULL),
('743003947', 'TX0100689', 'TX0100689', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Stephen', 'S', 'Burkhart', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2104897220', NULL, '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2104897220', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366487498', 0, 'N', 0, '2013-04-09', NULL, NULL, 29.6162, -98.493, NULL, NULL),
('743003947', 'TX0100690', 'TX0100690', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Stephen', 'S', 'Burkhart', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2104897220', NULL, '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2104897220', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366487498', 0, 'N', 0, '2013-04-09', NULL, NULL, 29.5058, -98.4803, NULL, NULL),
('743003947', 'TX0100692', 'TX0100692', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Ronald', 'W', 'Connor', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2103965300', NULL, '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2103965300', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811939820', 0, 'N', 0, '2013-07-10', NULL, NULL, 29.5058, -98.4803, NULL, NULL),
('743003947', 'TX0100693', 'TX0100693', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Ronald', 'W', 'Connor', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1200 Brooklyn Ave Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2103965300', NULL, '1200 Brooklyn Ave Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2103965300', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811939820', 0, 'N', 0, '2013-07-10', NULL, NULL, 29.4395, -98.4904, NULL, NULL),
('743003947', 'TX0100696', 'TX0100696', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Stephen', 'C', 'Drukker', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2829 Babcock Rd Ste 700', 'San Antonio', 'Bexar', 'TX', '78229', '2105931410', NULL, '2829 Babcock Rd Ste 700', 'San Antonio', 'Bexar', 'TX', '78229', '2105931410', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1699717587', 0, 'N', 0, '2013-08-22', NULL, NULL, 29.5129, -98.5916, NULL, NULL),
('743003947', 'TX0100697', 'TX0100697', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Stephen', 'C', 'Drukker', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2105931410', NULL, '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2105931410', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1699717587', 0, 'N', 0, '2013-08-22', NULL, NULL, 29.6162, -98.493, NULL, NULL),
('743003947', 'TX0100700', 'TX0100700', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Mayo', 'J', 'Galindo', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2104897230', NULL, '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2104897230', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-12-30', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1649212648', 0, 'N', 0, '2014-01-28', NULL, NULL, 29.5058, -98.4805, NULL, NULL),
('743003947', 'TX0100701', 'TX0100701', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Francisco', 'J', 'Garcia', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1200 Brooklyn Ave Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2103965305', NULL, '1200 Brooklyn Ave Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2103965305', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003858978', 0, 'N', 0, '2014-02-03', NULL, NULL, 29.4395, -98.4904, NULL, NULL),
('743003947', 'TX0100702', 'TX0100702', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Francisco', 'J', 'Garcia', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2103965305', NULL, '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2103965305', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003858978', 0, 'N', 0, '2014-02-03', NULL, NULL, 29.5058, -98.4803, NULL, NULL),
('743003947', 'TX0100703', 'TX0100703', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Francisco', 'J', 'Garcia', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2103965305', NULL, '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2103965305', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1003858978', 0, 'N', 0, '2014-02-03', NULL, NULL, 29.6152, -98.4924, NULL, NULL),
('743003947', 'TX0100704', 'TX0100704', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'David', 'M', 'Gonzalez', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1200 Brooklyn Ave Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2103965305', NULL, '1200 Brooklyn Ave Ste 320', 'San Antonio', 'Bexar', 'TX', '78212', '2103965305', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326080219', 0, 'N', 0, '2013-10-15', NULL, NULL, 29.4395, -98.4904, NULL, NULL),
('743003947', 'TX0100705', 'TX0100705', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'David', 'M', 'Gonzalez', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2103965305', NULL, '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2103965305', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326080219', 0, 'N', 0, '2013-10-15', NULL, NULL, 29.5058, -98.4803, NULL, NULL),
('743003947', 'TX0100708', 'TX0100708', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Alan', 'E', 'Hibberd', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2829 Babcock Rd Ste 700', 'San Antonio', 'Bexar', 'TX', '78229', '2103965250', NULL, '2829 Babcock Rd Ste 700', 'San Antonio', 'Bexar', 'TX', '78229', '2103965250', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093752909', 0, 'N', 0, '2013-06-27', NULL, NULL, 29.5129, -98.5916, NULL, NULL),
('743003947', 'TX0100709', 'TX0100709', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Alan', 'E', 'Hibberd', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2103965250', NULL, '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2103965250', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093752909', 0, 'N', 0, '2013-06-27', NULL, NULL, 29.6162, -98.493, NULL, NULL),
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('742625722', 'TX0100761', 'TX0100761', 'TXSATSTD', 'Alamo ENT Associates', 'William', 'C', 'Smith', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '19026 Stone Oak Pkwy Ste 110', 'San Antonio', 'Bexar', 'TX', '78258', '2106160096', NULL, '19026 Stone Oak Pkwy Ste 110', 'San Antonio', 'Bexar', 'TX', '78258', '2106160096', '          ', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336140680', 0, 'N', 0, '2013-05-28', NULL, NULL, 29.6193, -98.4939, NULL, NULL),
('742625722', 'TX0100762', 'TX0100762', 'TXSATSTD', 'Alamo ENT Associates', 'Jeffrey', 'S', 'Rosenbloom', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '19026 Stone Oak Pkwy Ste 110', 'San Antonio', 'Bexar', 'TX', '78258', '2105450404', NULL, '19026 Stone Oak Pkwy Ste 110', 'San Antonio', 'Bexar', 'TX', '78258', '2105450404', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', '', '', '', 'HCFA|UB|', '1386652378', 0, 'N', 0, '2014-06-17', NULL, NULL, 29.6192, -98.4942, NULL, NULL),
('742625722', 'TX0100763', 'TX0100763', 'TXSATSTD', 'Alamo ENT Associates', 'Charles', 'P', 'Biediger', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '19026 Stone Oak Pkwy Ste 110', 'San Antonio', 'Bexar', 'TX', '78258', '2105450404', NULL, '19026 Stone Oak Pkwy Ste 110', 'San Antonio', 'Bexar', 'TX', '78258', '2105450404', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033127022', 0, 'N', 0, '2013-04-04', NULL, NULL, 29.6192, -98.4942, NULL, NULL),
('742625722', 'TX0100764', 'TX0100764', 'TXSATSTD', 'Alamo ENT Associates', 'John', 'D', 'Edwards', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '19026 Stone Oak Pkwy Ste 110', 'San Antonio', 'Bexar', 'TX', '78258', '2106160096', NULL, '19026 Stone Oak Pkwy Ste 110', 'San Antonio', 'Bexar', 'TX', '78258', '2106160096', '          ', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-24', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336158294', 0, 'N', 0, '2013-06-27', NULL, NULL, 29.6193, -98.4939, NULL, NULL),
('742630478', 'TX0100765', 'TX0100765', 'TXSATSTD', 'Walter M Bain MD', 'Walter', 'M', 'Bain', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '1303 McCullough Ave Ste 242', 'San Antonio', 'Bexar', 'TX', '78212', '2102268982', '          ', '1303 McCullough Ave Ste 242', 'San Antonio', 'Bexar', 'TX', '78212', '2102268982', '          ', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-04-06', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1194890863', 0, 'N', 0, '2014-04-10', NULL, NULL, 29.4407, -98.4918, NULL, NULL),
('741895428', 'TX0100766', 'TX0100766', 'TXSATSTD', 'Ear Nose & Throat Clinics of San Antonio PA', NULL, NULL, 'Ear, Nose, & Throat Clinics of San Antonio, PA', NULL, 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', NULL, 'PO Box 29487', 'San Antonio', '', 'TX', '78229', '', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000006076', 0, 'y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('741895428', 'TX0200770', 'TX0200770', 'TXSATSTD', 'Ear Nose & Throat Clinics of San Antonio PA', 'Gerald', 'Paul', 'Laursen', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', NULL, 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000007213', 0, 'y', 0, '2013-09-12', NULL, NULL, 0, 0, NULL, NULL),
('741895428', 'TX0100771', 'TX0100771', 'TXSATSTD', 'Ear Nose & Throat Clinics of San Antonio PA', 'Harry', '', 'Schilling', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', NULL, 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578561825', 0, 'y', 0, '2013-06-19', NULL, NULL, 0, 0, NULL, NULL),
('741895428', 'TX0200772', 'TX0200772', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Stephen', 'J', 'Talley', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', NULL, 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'North East Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1770581852', 0, 'N', 0, '2013-07-16', NULL, NULL, 0, 0, NULL, NULL),
('741895428', 'TX0100773', 'TX0100773', 'TXSATSTD', 'Ear Nose & Throat Clinics of San Antonio PA', 'Gilbert', 'M', 'Ruiz', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', NULL, NULL, 'B', 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', NULL, 'PO Box 29487', 'San Antonio', '', 'TX', '78229', '', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008507', 0, 'y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('741895428', 'TX0100774', 'TX0100774', 'TXSATSTD', 'Ear Nose & Throat Clinics of San Antonio PA', 'Robert', 'P', 'Spears', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', NULL, 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1578555710', 0, 'y', 0, '2014-07-17', NULL, NULL, 0, 0, NULL, NULL),
('741895428', 'TX0100779', 'TX0100779', 'TXSATSTD', 'Ear Nose & Throat Clinics of San Antonio PA', 'Richard', 'K', 'Newman', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', NULL, 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007834', 0, 'y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('741895428', 'TX0100782', 'TX0100782', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Gerald', 'Paul', 'Laursen', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '4025 E Southcross Blvd Bldg 4 Ste 24', 'San Antonio', 'Bexar', 'TX', '78222', '2103371050', NULL, '4025 E Southcross Blvd Bldg 4 Ste 24', 'San Antonio', 'Bexar', 'TX', '78222', '2103371050', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000007213', 0, 'N', 0, '2013-09-12', NULL, NULL, 29.3751, -98.4158, NULL, NULL),
('741895428', 'TX0100783', 'TX0100783', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Harry', '', 'Schilling', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '4775 Hamilton Wolfe Bldg 1', 'San Antonio', 'Bexar', 'TX', '78229', '2106141326', NULL, '4775 Hamilton Wolfe Bldg 1', 'San Antonio', 'Bexar', 'TX', '78229', '2106141326', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578561825', 0, 'N', 0, '2013-06-19', NULL, NULL, 29.5212, -98.5815, NULL, NULL),
('741895428', 'TX0100784', 'TX0100784', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Stephen', 'J', 'Talley', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '8715 Village Dr Ste 516', 'San Antonio', 'Bexar', 'TX', '78217', '2105902597', NULL, '8715 Village Dr Ste 516', 'San Antonio', 'Bexar', 'TX', '78217', '2105902597', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'Baptist Medical Center', 'North East Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1770581852', 0, 'N', 0, '2013-07-16', NULL, NULL, 29.5187, -98.4281, NULL, NULL),
('741895428', 'TX0100785', 'TX0100785', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Gilbert', 'M', 'Ruiz', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', NULL, NULL, 'O', '4775 Hamilton Wolfe Bldg 1', 'San Antonio', 'Bexar', 'TX', '78229', '2106141326', NULL, 'PO Box 29487', 'San Antonio', '', 'TX', '78229', '', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008507', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.5212, -98.5815, NULL, NULL),
('741895428', 'TX0100786', 'TX0100786', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Robert', 'P', 'Spears', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '926 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102253136', NULL, '926 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102253136', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1578555710', 0, 'N', 0, '2014-07-17', NULL, NULL, 29.437, -98.4885, NULL, NULL),
('741895428', 'TX0000787', 'TX0000787', 'TX01', 'Ear Nose & Throat Clinics of San Antonio PA', 'Diana', 'H', 'Henderson', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '4775 Hamilton Wolfe Bldg 1', 'San Antonio', 'Bexar', 'TX', '78229', '2106158332', NULL, '4775 Hamilton Wolfe Bldg 1', 'San Antonio', 'Bexar', 'TX', '78229', '2106158332', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2007-01-01', '2012-08-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1083615884', 0, 'N', 0, '2014-07-17', NULL, NULL, 0, 0, NULL, NULL),
('741895428', 'TX0100791', 'TX0100791', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Richard', 'K', 'Newman', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '4775 Hamilton Wolfe Bldg 1', 'San Antonio', 'Bexar', 'TX', '78229', '2106158332', NULL, '4775 Hamilton Wolfe Bldg 1', 'San Antonio', 'Bexar', 'TX', '78229', '2106158332', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007834', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.5212, -98.5815, NULL, NULL),
('741895428', 'TX0100792', 'TX0100792', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Gerald', 'Paul', 'Laursen', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '12709 Toepperwein Ste 111', 'San Antonio', 'Bexar', 'TX', '78233', '2106569506', NULL, '12709 Toepperwein Ste 111', 'San Antonio', 'Bexar', 'TX', '78233', '2106569506', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000007213', 0, 'N', 0, '2013-09-12', NULL, NULL, 29.5532, -98.3483, NULL, NULL),
('741895428', 'TX0100793', 'TX0100793', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Harry', '', 'Schilling', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '12709 Toepperwein Ste 111', 'San Antonio', 'Bexar', 'TX', '78233', '2106569506', NULL, '12709 Toepperwein Ste 111', 'San Antonio', 'Bexar', 'TX', '78233', '2106569506', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578561825', 0, 'N', 0, '2013-06-19', NULL, NULL, 29.5532, -98.3483, NULL, NULL),
('741895428', 'TX0100794', 'TX0100794', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Stephen', 'J', 'Talley', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '12709 Toepperwein Ste 111', 'San Antonio', 'Bexar', 'TX', '78233', '2106569506', NULL, '12709 Toepperwein Ste 111', 'San Antonio', 'Bexar', 'TX', '78233', '2106569506', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'Baptist Medical Center', 'North East Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1770581852', 0, 'N', 0, '2013-07-16', NULL, NULL, 29.5532, -98.3483, NULL, NULL),
('741895428', 'TX0100795', 'TX0100795', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Gilbert', 'M', 'Ruiz', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', NULL, NULL, 'O', '926 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102253136', NULL, 'PO Box 29487', 'San Antonio', '', 'TX', '78229', '', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008507', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.437, -98.4885, NULL, NULL),
('741895428', 'TX0100796', 'TX0100796', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Robert', 'P', 'Spears', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104990732', NULL, '150 E Sonterra Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104990732', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1578555710', 0, 'N', 0, '2014-07-17', NULL, NULL, 29.6162, -98.493, NULL, NULL),
('741895428', 'TX0100801', 'TX0100801', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Harry', '', 'Schilling', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '4025 E Southcross Blvd Bldg 4 Ste 24', 'San Antonio', 'Bexar', 'TX', '78222', '2103371050', NULL, '4025 E Southcross Blvd Bldg 4 Ste 24', 'San Antonio', 'Bexar', 'TX', '78222', '2103371050', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1578561825', 0, 'N', 0, '2013-06-19', NULL, NULL, 29.3751, -98.4158, NULL, NULL),
('741895428', 'TX0100802', 'TX0100802', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Stephen', 'J', 'Talley', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'O', '150 E Sonterra Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104990732', NULL, '150 E Sonterra Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104990732', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'Baptist Medical Center', 'North East Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1770581852', 0, 'N', 0, '2013-07-16', NULL, NULL, 29.6152, -98.4924, NULL, NULL),
('741895428', 'TX0100803', 'TX0100803', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Robert', 'P', 'Spears', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '7500 Barlite Blvd Ste 211', 'San Antonio', 'Bexar', 'TX', '78224', '2109214921', NULL, '7500 Barlite Blvd Ste 211', 'San Antonio', 'Bexar', 'TX', '78224', '2109214921', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1578555710', 0, 'N', 0, '2014-07-17', NULL, NULL, 29.3528, -98.5466, NULL, NULL),
('741895428', 'TX0100806', 'TX0100806', 'TXSATSTD', 'Ear Nose & Throat Clinics of San Antonio PA', 'Manuel', '', 'Lopez', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', NULL, 'PO Box 29487', 'San Antonio', 'Bexar', 'TX', '78229', '2106160283', '', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770505984', 0, 'y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('741895428', 'TX0100811', 'TX0100811', 'TXSATSTD', 'Ear Nose and Throat Clinics of San Antonio', 'Manuel', '', 'Lopez', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104990732', NULL, '150 E Sonterra Blvd Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104990732', '          ', 'TXSURGE', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770505984', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.6152, -98.4924, NULL, NULL),
('741901441', 'TX0100820', 'TX0100820', 'TXSATSTD', 'Gloria B Abraham-Cox MD', 'Gloria', 'B', 'Abraham-Cox', 'MD', 'Pediatrics', '', '', NULL, 'O', '311 Camden Ste 412', 'San Antonio', 'Bexar', 'TX', '78215', '2102228798', NULL, '311 Camden Ste 412', 'San Antonio', 'Bexar', 'TX', '78215', '2102228798', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1295844132', 0, 'N', 0, '2014-05-16', NULL, NULL, 29.4345, -98.4923, NULL, NULL),
('746141855', 'TX0100822', 'TX0100822', 'TXSATSTD', 'Pediatrics and Adolescents', 'Henry', 'J', 'Lipsitt', 'MD', 'Pediatrics', '', '', NULL, 'O', '3111 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107327141', NULL, '3111 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107327141', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1629091269', 0, 'N', 0, '2013-04-09', NULL, NULL, 29.4642, -98.4993, NULL, NULL),
('746141855', 'TX0100823', 'TX0100823', 'TXSATSTD', 'Pediatrics and Adolescents', 'David', 'W', 'Johnson', 'MD', 'Pediatrics', '', '', NULL, 'O', '3111 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107327141', NULL, '3111 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107327141', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1326061011', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.4642, -98.4993, 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
('746141855', 'TX0100824', 'TX0100824', 'TXSATSTD', 'Pediatrics and Adolescents', 'Stephen', 'A', 'Maxwell', 'MD', 'Pediatrics', '', '', NULL, 'O', '3111 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107327141', NULL, '3111 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107327141', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1649293234', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.4642, -98.4993, NULL, NULL),
('746141855', 'TX0100825', 'TX0100825', 'TXSATSTD', 'Pediatrics & Adolescents', 'Shaylon', 'D', 'Rettig', 'MD', 'Pediatrics', '', '', NULL, 'O', '3111 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107327141', NULL, '3111 San Pedro Ave', 'San Antonio', 'Bexar', 'TX', '78212', '2107327141', '          ', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1679595045', 0, 'N', 0, '2012-09-04', NULL, NULL, 29.4646, -98.4996, NULL, NULL),
('742962755', 'TX0100826', 'TX0100826', 'TXSATSTD', 'Stone Oak Pediatrics', 'Annette', NULL, 'Gunsberg', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '540 Oak Ctr Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104032229', NULL, '540 Oak Ctr', 'San Antonio', '', 'TX', '78258', '', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000006511', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.6189, -98.492, NULL, NULL),
('742962755', 'TX0100828', 'TX0100828', 'TXSATSTD', 'Stone Oak Pediatrics', 'Sara', 'D', 'Bourland', 'MD', 'Pediatrics', '', '', NULL, 'O', '540 Oak Ctr Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104032229', NULL, '540 Oak Ctr Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2104032229', '          ', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-29', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1801987342', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.6189, -98.4939, NULL, NULL),
('742478680', 'TX0100830', 'TX0100830', 'TXSATSTD', 'Ostrower Nieheisel & Davis MD', 'Laura', 'F', 'Davis', 'MD', 'Pediatrics', '', '', NULL, 'O', '4499 Medical Dr Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106144499', NULL, '4499 Medical Dr Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106144499', '          ', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-12-31', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1578666947', 0, 'N', 0, '2013-12-10', NULL, NULL, 29.5105, -98.5737, NULL, NULL),
('742478680', 'TX0100831', 'TX0100831', 'TXSATSTD', 'Ostrower Nieheisel & Davis MD', 'Margaret', 'D', 'Neiheisel', 'MD', 'Pediatrics', '', '', NULL, 'O', '4499 Medical Dr Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106144499', NULL, '4499 Medical Dr Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106144499', '          ', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-12-31', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1073627741', 0, 'N', 0, '2014-03-24', NULL, NULL, 29.5105, -98.5737, NULL, NULL),
('742478680', 'TX0100832', 'TX0100832', 'TXSATSTD', 'Ostrower Nieheisel & Davis MD', 'Valerie', 'G', 'Ostrower', 'MD', 'Pediatrics', '', '', NULL, 'O', '4499 Medical Dr Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106144499', NULL, '4499 Medical Dr Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2106144499', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659328359', 0, 'N', 0, '2014-04-04', NULL, NULL, 29.5105, -98.5737, NULL, NULL),
('742357119', 'TX0100838', 'TX0100838', 'TXSATSTD', 'Terry L Westfield MD', 'Terry', 'L', 'Westfield', 'MD', 'Ear, Nose and Throat', 'Plastic Surgery', '', NULL, 'O', '540 Madison Oak Dr Ste 370', 'San Antonio', 'Bexar', 'TX', '78258', '2106920012', NULL, '540 Madison Oak Dr Ste 370', 'San Antonio', 'Bexar', 'TX', '78258', '2106920012', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1760512560', 0, 'N', 0, '2013-04-17', NULL, NULL, 29.6212, -98.4921, NULL, NULL),
('742780060', 'TX0100839', 'TX0100839', 'TXSATSTD', 'Advanced Family Footcare Centers', 'Robert', 'E', 'Graser', 'DPM', 'Podiatry', '', '', NULL, 'O', '98 Briggs Ave Ste 925', 'San Antonio', 'Bexar', 'TX', '78224', '2109221551', NULL, '98 Briggs Ave Ste 925', 'San Antonio', 'Bexar', 'TX', '78224', '2109221551', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1457300931', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.3552, -98.551, NULL, NULL),
('742859617', 'TX0100841', 'TX0100841', 'TXSATSTD', 'Southeast Foot Care', 'Wilburn', 'E', 'Thomas', 'DPM', 'Podiatry', '', '', NULL, 'O', '4320 S Gevers Ste 300', 'San Antonio', 'Bexar', 'TX', '78223', '2105334455', NULL, '4320 S Gevers Ste 300', 'San Antonio', 'Bexar', 'TX', '78223', '2105334455', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1669530523', 0, 'N', 0, '2013-07-10', NULL, NULL, 29.3754, -98.4567, NULL, NULL),
('320106254', 'TX0100842', 'TX0100842', 'TXSATSTD', 'Lone Star Foot & Ankle Center', 'Robert', 'P', 'Cyr', 'DPM', 'Podiatry', '', '', NULL, 'O', '343 W Houston St Ste 612', 'San Antonio', 'Bexar', 'TX', '78205', '2102124595', NULL, '343 W Houston St Ste 612', 'San Antonio', 'Bexar', 'TX', '78205', '2102124595', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-01-07', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1285735456', 0, 'N', 0, '2014-01-17', NULL, NULL, 29.4267, -98.4973, NULL, NULL),
('113676182', 'TX0100844', 'TX0100844', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Arush', 'K', 'Angirasa', 'DPM', 'Podiatry', '', '', NULL, 'O', '414 Navarro Ste 811', 'San Antonio', 'Bexar', 'TX', '78205', '2102221077', '2102221215', '414 Navarro Ste 811', 'San Antonio', 'Bexar', 'TX', '78205', '2102221077', '2102221215', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740271196', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.4256, -98.4895, NULL, NULL),
('113676182', 'TX0100845', 'TX0100845', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Richard', 'L', 'Childers', 'DPM', 'Podiatry', '', '', NULL, 'O', '28580 IH 10 W Ste 3', 'Boerne', 'Kendall', 'TX', '78006', '8309815150', '8309815159', '28580 IH 10 W Ste 3', 'Boerne', 'Kendall', 'TX', '78006', '8309815150', '8309815159', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124009337', 0, 'N', 0, '2013-04-30', NULL, NULL, 29.7222, -98.6683, NULL, NULL),
('113676182', 'TX0100850', 'TX0100850', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Michael', 'J', 'Barrett', 'DPM', 'Podiatry', '', '', NULL, 'O', '5307 Broadway 2nd Flr', 'San Antonio', 'Bexar', 'TX', '78209', '2104793233', '          ', '5307 Broadway 2nd Flr', 'San Antonio', 'Bexar', 'TX', '78209', '2104793233', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1760473235', 0, 'N', 0, '2014-05-28', NULL, NULL, 29.4762, -98.4629, NULL, NULL),
('113676182', 'TX0100851', 'TX0100851', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Michael', 'J', 'Barrett', 'DPM', 'Podiatry', '', '', NULL, 'O', '414 Navarro Ste 1125', 'San Antonio', 'Bexar', 'TX', '78205', '2102221077', NULL, '414 Navarro Ste 1125', 'San Antonio', 'Bexar', 'TX', '78205', '2102221077', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1760473235', 0, 'N', 0, '2014-05-28', NULL, NULL, 29.4254, -98.4897, NULL, NULL),
('113676182', 'TX0100853', 'TX0100853', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Charles', 'M', 'Melton', 'DPM', 'Podiatry', '', '', NULL, 'O', '11212 Hwy 151 Ste 390', 'San Antonio', 'Bexar', 'TX', '78251', '2108291880', NULL, '11212 Hwy 151 Ste 390', 'San Antonio', 'Bexar', 'TX', '78251', '2108291880', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962493148', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.4801, -98.7053, NULL, NULL),
('113676182', 'TX0100855', 'TX0100855', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Charles', 'M', 'Melton', 'DPM', 'Podiatry', '', '', NULL, 'O', '1804 NE Loop 410 Ste 200', 'San Antonio', 'Bexar', 'TX', '78217', '2108291880', NULL, '1804 NE Loop 410 Ste 200', 'San Antonio', 'Bexar', 'TX', '78217', '2108291880', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962493148', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.5157, -98.435, NULL, NULL),
('113676182', 'TX0100856', 'TX0100856', 'TXSATSTD', 'The Podiatry Group of South Texas', 'James', 'E', 'Miller', 'DPM', 'Podiatry', '', '', NULL, 'O', '12602 Toepperwein Rd Ste 218', 'San Antonio', 'Bexar', 'TX', '78233', '2106500314', NULL, '12602 Toepperwein Rd Ste 218', 'San Antonio', 'Bexar', 'TX', '78233', '2106500314', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1316938590', 0, 'N', 0, '2013-04-05', NULL, NULL, 0, 0, NULL, NULL),
('113676182', 'TX0100857', 'TX0100857', 'TXSATSTD', 'The Podiatry Group of South Texas', 'James', 'E', 'Miller', 'DPM', 'Podiatry', '', '', NULL, 'O', '4025 E Southcross Blvd Ste 4', 'San Antonio', 'Bexar', 'TX', '78222', '2103338441', NULL, '4025 E Southcross Blvd Ste 4', 'San Antonio', 'Bexar', 'TX', '78222', '2103338441', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1316938590', 0, 'N', 0, '2013-04-05', NULL, NULL, 29.3748, -98.4155, NULL, NULL),
('113676182', 'TX0100859', 'TX0100859', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Robert', 'R', 'Vranes', 'DPM', 'Podiatry', '', '', NULL, 'O', '9150 Huebner Rd Ste 270', 'San Antonio', 'Bexar', 'TX', '78240', '2105617080', '2105617040', '9150 Huebner Ste 270', 'San Antonio', 'Bexar', 'TX', '78240', '2105617080', '2105617040', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1770574956', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.5277, -98.5959, NULL, NULL),
('113676182', 'TX0100861', 'TX0100861', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Peter', 'J', 'Williams', 'DPM', 'Podiatry', '', '', NULL, 'O', '1303 McCullough Ave Ste 348', 'San Antonio', 'Bexar', 'TX', '78212', '2102274164', '2102276708', '1303 McCullough Ave Ste 348', 'San Antonio', 'Bexar', 'TX', '78212', '2102274164', '2102276708', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1083605273', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.4407, -98.4918, NULL, NULL),
('113676182', 'TX0100863', 'TX0100863', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Peter', 'J', 'Williams', 'DPM', 'Podiatry', '', '', NULL, 'O', '128 W Bandera Ste C', 'San Antonio', 'Kendall', 'TX', '78006', '2102274164', '2102276708', '128 W Bandera Ste C', 'San Antonio', 'Kendall', 'TX', '78006', '2102274164', '2102276708', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-06', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1083605273', 0, 'N', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('742897101', 'TX0100865', 'TX0100865', 'TXSATSTD', 'Catherine M Rezendes DPM', 'Catherine', 'M', 'Rezendes', 'DPM', 'Podiatry', '', '', NULL, 'O', '12413 Judson Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78233', '2106559965', NULL, '12413 Judson Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78233', '2106559965', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1720002579', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.5513, -98.3486, NULL, NULL),
('742778964', 'TX0100866', 'TX0100866', 'TXSATSTD', 'Independent Medical Associates', 'Peter', 'A', 'Petroff', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2833 Babcock Rd Ste 435', 'San Antonio', 'Bexar', 'TX', '78229', '2106145855', NULL, '2833 Babcock Rd Ste 435', 'San Antonio', 'Bexar', 'TX', '78229', '2106145855', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-01', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1588645659', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.5133, -98.5912, NULL, NULL),
('161751617', 'TX0100889', 'TX0100889', 'TXSATSTD', 'Rheumatology Associates of South Texas', 'Everett', '', 'Allen', 'MD', 'Rheumatology', '', '', NULL, 'O', '19272 Stone Oak Pkwy Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2102658851', NULL, '19272 Stone Oak Pkwy', 'San Antonio', 'Bexar', 'TX', '78258', '2102658851', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, NULL, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609846641', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.63, -98.4952, NULL, NULL),
('161751617', 'TX0100890', 'TX0100890', 'TXSATSTD', 'Rheumatology Associates of South Texas', 'Kevin', NULL, 'Kempf', 'MD', 'Rheumatology', NULL, NULL, NULL, 'O', '19272 Stone Oak Pkwy Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2102658851', NULL, '19272 Stone Oak Pkwy', 'San Antonio', '', 'TX', '78258', '', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000007065', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.63, -98.4952, NULL, NULL),
('161751617', 'TX0100891', 'TX0100891', 'TXSATSTD', 'Rheumatology Associates of South Texas', 'Thomas', '', 'Rennie', 'MD', 'Rheumatology', '', '', NULL, 'O', '19272 Stone Oak Pkwy Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2102658851', NULL, '19272 Stone Oak Pkwy Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2102658851', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000008358', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.63, -98.4952, NULL, NULL),
('741850643', 'TX0100898', 'TX0100898', 'TXSATSTD', 'General Surgical Associates', 'Michael', 'A', 'Cardenas', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', NULL, '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1649200809', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('741850643', 'TX0100899', 'TX0100899', 'TXSATSTD', 'General Surgical Associates', 'Bruce', 'E', 'Conway', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', NULL, '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1629005996', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('741850643', 'TX0100900', 'TX0100900', 'TXSATSTD', 'General Surgical Associates', 'Brittany', 'B', 'DeBerry', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', NULL, '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1891722179', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('741850643', 'TX0100901', 'TX0100901', 'TXSATSTD', 'General Surgical Associates', 'Brad', 'W', 'Gurwitz', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', NULL, '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1689604852', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('741850643', 'TX0100902', 'TX0100902', 'TXSATSTD', 'General Surgical Associates', 'Joe', 'E', 'Johnston', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', NULL, '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', '', '', '', 'HCFA|UB|', '1679507123', 0, 'N', 0, '2013-09-27', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('741850643', 'TX0100903', 'TX0100903', 'TXSATSTD', 'General Surgical Associates', 'Douglas', 'W', 'Robinson', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', NULL, '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1386678837', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('741850643', 'TX0100904', 'TX0100904', 'TXSATSTD', 'General Surgical Associates', 'Jonathan', 'O', 'Tramer', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', NULL, '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1639103195', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('741850643', 'TX0100905', 'TX0100905', 'TXSATSTD', 'General Surgical Associates', 'Russell', 'L', 'Woodard', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', NULL, '8042 Wurzbach Rd Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106145113', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1346274800', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742858503', 'TX0100906', 'TX0100906', 'TXSATSTD', 'Gerardo E Carcamo MD', 'Gerardo', 'E', 'Carcamo', 'MD', 'General Surgery', '', '', NULL, 'O', '414 Navarro Ste 810', 'San Antonio', 'Bexar', 'TX', '78205', '2102201726', NULL, '414 Navarro Ste 810', 'San Antonio', 'Bexar', 'TX', '78205', '2102201726', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1568484327', 0, 'N', 0, '2014-01-17', NULL, NULL, 29.4254, -98.4897, NULL, NULL),
('457709952', 'TX0100908', 'TX0100908', 'TXSATSTD', 'Mimari Surgical Associates', 'George', 'E', 'Mimari', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 630', 'San Antonio', 'Bexar', 'TX', '78229', '2106145067', NULL, '8042 Wurzbach Rd Ste 630', 'San Antonio', 'Bexar', 'TX', '78229', '2106145067', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1982602546', 0, 'N', 0, '2013-07-19', NULL, NULL, 29.5151, -98.5765, NULL, NULL),
('742067539', 'TX0100909', 'TX0100909', 'TXSATSTD', 'South Texas Oncology and Hematology', 'Mark', 'C', 'Rittenhouse', 'MD', 'General Surgery', '', '', NULL, 'O', '7940 Floyd Curl Dr Ste 840', 'San Antonio', 'Bexar', 'TX', '78229', '2106143349', NULL, '7940 Floyd Curl Dr Ste 840', 'San Antonio', 'Bexar', 'TX', '78229', '2106143349', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1538155270', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.5117, -98.5756, NULL, NULL),
('742709196', 'TX0100912', 'TX0100912', 'TXSATSTD', 'William H Bradshaw MD', 'William', 'H', 'Bradshaw', 'MD', 'General Surgery', '', '', NULL, 'O', '8534 Village Dr Ste B', 'San Antonio', 'Bexar', 'TX', '78217', '2106546340', NULL, '8534 Village Dr Ste B', 'San Antonio', 'Bexar', 'TX', '78217', '2106546340', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1053310573', 0, 'N', 0, '2013-04-17', NULL, NULL, 29.5174, -98.4272, NULL, NULL),
('742999913', 'TX0100913', 'TX0100913', 'TXSATSTD', 'Joseph K Wright MD', 'Joseph', 'K', 'Wright', 'MD', 'General Surgery', '', '', NULL, 'O', '414 Navarro Ste 810', 'San Antonio', 'Bexar', 'TX', '78205', '2102201726', NULL, '414 Navarro Ste 810', 'San Antonio', 'Bexar', 'TX', '78205', '2102201726', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1225057680', 0, 'N', 0, '2013-12-12', NULL, NULL, 29.4254, -98.4897, NULL, NULL),
('742999557', 'TX0100914', 'TX0100914', 'TXSATSTD', 'Vincent A Caldarola MD', 'Vincent A', '', 'Caldarola', 'MD', 'General Surgery', 'Colon and Rectal Surgery', '', NULL, 'O', '19016 Stone Oak Pkwy Ste 240', 'San Antonio', 'Bexar', 'TX', '78258', '2106143565', '2106143563', '19016 Stone Oak Pkwy Ste 240', 'San Antonio', 'Bexar', 'TX', '78258', '2106143565', '2106143563', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1124043591', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.6185, -98.4935, NULL, NULL),
('742999557', 'TX0100915', 'TX0100915', 'TXSATSTD', 'Vincent A Caldarola MD', 'Vincent A', '', 'Caldarola', 'MD', 'General Surgery', 'Colon and Rectal Surgery', '', NULL, 'O', '4499 Medical Dr Ste 250', 'San Antonio', 'Bexar', 'TX', '78229', '2106143565', '2106143563', '4499 Medical Dr Ste 250', 'San Antonio', 'Bexar', 'TX', '78229', '2106143565', '2106143563', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1124043591', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.5094, -98.5732, NULL, NULL),
('742719352', 'TX0100918', 'TX0100918', 'TXSATSTD', 'Urology of San Antonio', 'Arthur', 'S', 'Centeno', 'MD', 'Urology', '', '', NULL, 'O', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1386624740', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.4254, -98.4897, NULL, NULL),
('742719352', 'TX0100919', 'TX0100919', 'TXSATSTD', 'Urology of San Antonio', 'Christopher', 'W', 'Graham', 'MD', 'Urology', '', '', NULL, 'O', '12709 Toepperwein Ste 206', 'San Antonio', 'Bexar', 'TX', '78233', '2105648000', '2105907945', '12709 Toepperwein Ste 206', 'San Antonio', 'Bexar', 'TX', '78233', '2105648000', '2105907945', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861472961', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.5535, -98.3472, NULL, NULL),
('742719352', 'TX0100920', 'TX0100920', 'TXSATSTD', 'Urology of San Antonio', 'Timothy', 'C', 'Hlavinka', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825655', '7909 Fredericksburg Rd Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825655', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982684098', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('742719352', 'TX0100921', 'TX0100921', 'TXSATSTD', 'Urology of San Antonio', 'Clayton', 'H', 'Hudnall', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 125', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825520', '7909 Fredericksburg Rd Ste 125', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825520', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1952381063', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('742719352', 'TX0100923', 'TX0100923', 'TXSATSTD', 'Urology of San Antonio', 'Thomas', 'K', 'O''Neill', 'MD', 'Urology', NULL, NULL, NULL, 'O', '255 E Sonterra Ste 203', 'San Antonio', 'Bexar', 'TX', '78258', '2104995158', '2104995259', '7909 Fredricksburg', 'San Antonio', '', 'TX', '78229', '', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326028713', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.6171, -98.4906, NULL, NULL),
('742719352', 'TX0100924', 'TX0100924', 'TXSATSTD', 'Urology of San Antonio', 'Juan', 'A', 'Reyna', 'MD', 'Urology', '', '', NULL, 'O', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1265412795', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.4254, -98.4897, NULL, NULL),
('742719352', 'TX0100925', 'TX0100925', 'TXSATSTD', 'Urology of San Antonio', 'Luis', 'R', 'Rivera', 'MD', 'Urology', '', '', NULL, 'O', '4212 E Southcross Blvd Ste 125', 'San Antonio', 'Bexar', 'TX', '78222', '2103376228', '2103046476', '4212 E Southcross Blvd Ste 125', 'San Antonio', 'Bexar', 'TX', '78222', '2103376228', '2103046476', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-04-08', 0, 0, 0, 'Mission Trail Baptist Hospital', '', '', '', 'HCFA|UB|', '1780664177', 0, 'N', 0, '2014-04-11', NULL, NULL, 29.3748, -98.412, NULL, NULL),
('742719352', 'TX0100926', 'TX0100926', 'TXSATSTD', 'Urology of San Antonio', 'Daniel', 'R', 'Saltzstein', 'MD', 'Urology', '', '', NULL, 'O', '255 E Sonterra Ste 203', 'San Antonio', 'Bexar', 'TX', '78258', '2104995158', '2104995259', '255 E Sonterra Ste 203', 'San Antonio', 'Bexar', 'TX', '78258', '2104995158', '2104995259', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922088947', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.6164, -98.4911, NULL, NULL),
('742719352', 'TX0100927', 'TX0100927', 'TXSATSTD', 'Urology of San Antonio', 'Rene', 'A', 'Sepulveda', 'MD', 'Urology', '', '', NULL, 'O', '12709 Toepperwein Ste 206', 'San Antonio', 'Bexar', 'TX', '78233', '2105648000', '2105907945', '12709 Toepperwein Ste 206', 'San Antonio', 'Bexar', 'TX', '78233', '2105648000', '2105907945', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1710967732', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.5535, -98.3472, NULL, NULL),
('742719352', 'TX0100928', 'TX0100928', 'TXSATSTD', 'Urology of San Antonio', 'Randall', 'P', 'Singleton', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', '7909 Fredericksburg Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891775284', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('742719352', 'TX0100929', 'TX0100929', 'TXSATSTD', 'Urology of San Antonio', 'C', 'R', 'Spence', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 125', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', '7909 Fredericksburg Rd Ste 125', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336129733', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('742719352', 'TX0100930', 'TX0100930', 'TXSATSTD', 'Urology of San Antonio', 'David', 'R', 'Talley', 'MD', 'Urology', '', '', NULL, 'O', '12709 Toepperwein Ste 206', 'San Antonio', 'Bexar', 'TX', '78233', '2105648000', '2105907945', '12709 Toepperwein Ste 206', 'San Antonio', 'Bexar', 'TX', '78233', '2105648000', '2105907945', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1770563173', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.5535, -98.3472, NULL, NULL),
('742719352', 'TX0100932', 'TX0100932', 'TXSATSTD', 'Urology of San Antonio', 'Patricia', 'J', 'Terry', 'MD', 'Urology', '', '', NULL, 'O', '255 E Sonterra Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2105810376', '2105810382', '255 E Sonterra Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2105810376', '2105810382', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376523308', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.6164, -98.4911, NULL, NULL),
('742719352', 'TX0100934', 'TX0100934', 'TXSATSTD', 'Urology of San Antonio', 'Andrew', 'A', 'Tobon', 'MD', 'Urology', '', '', NULL, 'O', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174503106', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.4254, -98.4897, NULL, NULL),
('742719352', 'TX0100935', 'TX0100935', 'TXSATSTD', 'Urology of San Antonio', 'Joan', 'T', 'Meaney', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 130', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825636', '7909 Fredericksburg Rd Ste 130', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825636', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710967831', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.5113, -98.5683, NULL, NULL),
('742719352', 'TX0100936', 'TX0100936', 'TXSATSTD', 'Urology of San Antonio', 'William', 'J', 'Harmon', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 135', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825552', '7909 Fredericksburg Rd Ste 135', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825552', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1104806207', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('742719352', 'TX0100937', 'TX0100937', 'TXSATSTD', 'Urology of San Antonio', 'Naveen', '', 'Kella', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', '7909 Fredericksburg Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1154301182', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('742719352', 'TX0100938', 'TX0100938', 'TXSATSTD', 'Urology of San Antonio', 'LeRoy', 'A', 'Jones', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825655', '7909 Fredericksburg Rd Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825655', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1518947613', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('742719352', 'TX0100944', 'TX0100944', 'TXSATSTD', 'Urology of San Antonio', 'Peggy', '', 'Francis', 'NP', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825655', '7909 Fredericksburg Rd Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2105825655', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1013926542', 0, 'Y', 0, '2013-05-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('741694904', 'TX0100957', 'TX0100957', 'TXSATSTD', 'Child Care Associates', 'Barbara', 'P', 'Belcher', 'MD', 'Pediatrics', '', '', NULL, 'O', '203 E Evergreen', 'San Antonio', 'Bexar', 'TX', '78212', '2102257171', NULL, '203 E Evergreen', 'San Antonio', 'Bexar', 'TX', '78212', '2102257171', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598885089', 0, 'N', 0, '2013-05-30', NULL, NULL, 29.4428, -98.493, NULL, NULL),
('741799802', 'TX0100959', 'TX0100959', 'TXSATSTD', 'Heliodoro V Boone MD', 'Heliodoro', 'V', 'Boone', 'MD', 'General Surgery', '', '', NULL, 'O', '343 W Houston St Ste 512', 'San Antonio', 'Bexar', 'TX', '78205', '2102254316', NULL, '343 W Houston St Ste 512', 'San Antonio', 'Bexar', 'TX', '78205', '2102254316', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1649262205', 0, 'N', 0, '2013-07-12', NULL, NULL, 29.4264, -98.4967, NULL, NULL),
('741849254', 'TX0100960', 'TX0100960', 'TXSATSTD', 'Morris E Franklin MD', 'Morris', 'E', 'Franklin', 'MD', 'General Surgery', '', '', NULL, 'O', '4242 E Southcross Blvd Ste 1', 'San Antonio', 'Bexar', 'TX', '78222', '2103337510', '          ', '4242 E Southcross Blvd Ste 1', 'San Antonio', 'Bexar', 'TX', '78222', '2103337510', '          ', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-07-14', 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1932104791', 0, 'N', 0, '2014-07-18', NULL, NULL, 29.3749, -98.4113, NULL, NULL),
('742246239', 'TX0100961', 'TX0100961', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Jeffery', 'S', 'Bullock', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1201 S Main St Ste 122', 'Boerne', 'Kendall', 'TX', '78006', '2105911409', NULL, '1201 S Main St Ste 122', 'Boerne', 'Kendall', 'TX', '78006', '2105911409', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '1528062288', 0, 'N', 0, '2013-09-24', NULL, NULL, 29.7783, -98.7278, NULL, NULL),
('742246239', 'TX0100962', 'TX0100962', 'TXSATSTD', 'San Antonio Gastroenterology Associates', '', '', 'San Antonio Gastroenterology Associates PA', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1201 S Main st Ste 119', 'Boerne', 'Kendall', 'TX', '78006', '2103596446', NULL, '1201 S Main st Ste 119', 'Boerne', 'Kendall', 'TX', '78006', '2103596446', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427150697', 0, 'Y', 0, '2013-05-01', NULL, NULL, 29.7783, -98.7278, NULL, NULL),
('742246239', 'TX0100963', 'TX0100963', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Ernesto', '', 'Guerra', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1558366435', 0, 'y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('742246239', 'TX0100964', 'TX0100964', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Richard', 'L', 'Otero', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1881699734', 0, 'y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742246239', 'TX0100965', 'TX0100965', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Steven', 'R', 'Ramos', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'St Lukes Baptist Hospital', 'Mission Trail Baptist Hospital', NULL, 'HCFA|UB|', '1346244936', 0, 'y', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('742246239', 'TX0100966', 'TX0100966', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Joseph', 'E', 'Johnson', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'St Lukes Baptist Hospital', 'Mission Trail Baptist Hospital', NULL, 'HCFA|UB|', '1477557072', 0, 'y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742246239', 'TX0100967', 'TX0100967', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Belinda', '', 'Ramirez', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1548264146', 0, 'y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742246239', 'TX0100968', 'TX0100968', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Eddie', '', 'Flores', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'St Lukes Baptist Hospital', 'Mission Trail Baptist Hospital', NULL, 'HCFA|UB|', '1568466217', 0, 'y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742246239', 'TX0100969', 'TX0100969', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Michael', 'S', 'Lindner', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'St Lukes Baptist Hospital', 'Mission Trail Baptist Hospital', NULL, 'HCFA|UB|', '1649274309', 0, 'y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742246239', 'TX0100970', 'TX0100970', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Jeffery', 'S', 'Bullock', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', 'St Lukes Baptist Hospital', NULL, 'HCFA|UB|', '1528062288', 0, 'y', 0, '2013-09-24', NULL, NULL, 0, 0, NULL, NULL),
('742246239', 'TX0100971', 'TX0100971', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Michael', '', 'Rensch', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1366446023', 0, 'y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742246239', 'TX0100972', 'TX0100972', 'TXSATSTD', 'San Antonio Gastroenterology Associates', 'Leonard', '', 'Duran', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', NULL, 'PO Box 840390', 'Dallas', 'Dallas', 'TX', '75284', '2102710606', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'Mission Trail Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1144224809', 0, 'y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('742939835', 'TX0100975', 'TX0100975', 'TXSATSTD', 'Arthritis and Osteoporosis Center of South Texas', 'John', 'P', 'Huff', 'MD,PHD', 'Rheumatology', '', '', NULL, 'O', '14615 San Pedro Ste 105', 'San Antonio', 'Bexar', 'TX', '78232', '2104040020', NULL, '14615 San Pedro Ste 105', 'San Antonio', 'Bexar', 'TX', '78232', '2104040020', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1912978933', 0, 'N', 0, '2014-01-28', NULL, NULL, 29.5753, -98.479, NULL, NULL),
('742939835', 'TX0100976', 'TX0100976', 'TXSATSTD', 'Arthritis and Osteoporosis Center of South Texas', 'James', '', 'Wild', 'MD', 'Rheumatology', '', '', NULL, 'O', '14615 San Pedro Ste 105', 'San Antonio', 'Bexar', 'TX', '78232', '2104040020', NULL, '14615 San Pedro Ste 105', 'San Antonio', 'Bexar', 'TX', '78232', '2104040020', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1659343291', 0, 'N', 0, '2014-01-20', NULL, NULL, 29.5753, -98.479, NULL, NULL),
('742939835', 'TX0100977', 'TX0100977', 'TXSATSTD', 'Arthritis and Osteoporosis Center of South Texas', 'William', 'W', 'White', 'MD', 'Rheumatology', '', '', NULL, 'O', '14615 San Pedro Ste 105', 'San Antonio', 'Bexar', 'TX', '78232', '2104040020', NULL, '14615 San Pedro Ste 105', 'San Antonio', 'Bexar', 'TX', '78232', '2104040020', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1467425686', 0, 'N', 0, '2013-04-22', NULL, NULL, 29.5747, -98.4798, NULL, NULL),
('742939835', 'TX0100979', 'TX0100979', 'TXSATSTD', 'Arthritis and Osteoporosis Center of South Texas', 'John', 'P', 'Huff', 'MD,PHD', 'Rheumatology', '', '', NULL, 'B', 'PO Box 2207', 'San Antonio', 'Bexar', 'TX', '78298', '2104040020', NULL, 'PO Box 2207', 'San Antonio', 'Bexar', 'TX', '78298', '2104040020', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1912978933', 0, 'y', 0, '2014-01-28', NULL, NULL, 0, 0, NULL, NULL),
('742939835', 'TX0100980', 'TX0100980', 'TXSATSTD', 'Arthritis and Osteoporosis Center of South Texas', 'James', '', 'Wild', 'MD', 'Rheumatology', '', '', NULL, 'B', 'PO Box 2207', 'San Antonio', 'Bexar', 'TX', '78298', '2104040020', NULL, 'PO Box 2207', 'San Antonio', 'Bexar', 'TX', '78298', '2104040020', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1659343291', 0, 'y', 0, '2014-01-20', NULL, NULL, 0, 0, NULL, NULL),
('742939835', 'TX0100981', 'TX0100981', 'TXSATSTD', 'Arthritis and Osteoporosis Center of South Texas', 'William', 'W', 'White', 'MD', 'Rheumatology', '', '', NULL, 'B', 'PO Box 2207', 'San Antonio', 'Bexar', 'TX', '78298', '2104040020', NULL, 'PO Box 2207', 'San Antonio', 'Bexar', 'TX', '78298', '2104040020', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1467425686', 0, 'N', 0, '2013-04-22', NULL, NULL, 0, 0, NULL, NULL),
('742763430', 'TX0100986', 'TX0100986', 'TXSATSTD', 'Allergy Asthma and Immunology Associates of South Texas', 'William', 'T', 'Kniker', 'MD', 'Allergy and Immunology', 'Pediatric Allergy and Immunology', '', NULL, 'O', '2414 Babcock Rd Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106160882', NULL, '2414 Babcock Rd Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106160882', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-09-04', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1710978663', 0, 'N', 0, '2013-09-11', NULL, NULL, 29.5051, -98.5858, NULL, NULL),
('742763430', 'TX0200987', 'TX0200987', 'TXSATSTD', 'Allergy Asthma and Immunology Associates of South Texas', 'Melissa', 'E', 'Garcia', 'PA-C', 'Allergy and Immunology', '', '', NULL, 'O', '2414 Babcock Rd Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106160882', NULL, '2414 Babcock Ste 109', 'San Antonio', 'Bexar', 'TX', '78229', '2106160882', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205801230', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.5057, -98.5856, NULL, NULL),
('742789421', 'TX0101016', 'TX0101016', 'TXSATSTD', 'Theodore W Bedard MD', 'Theodore', 'W', 'Bedard', 'MD', 'Rheumatology', NULL, NULL, NULL, 'O', '8601 Village Dr Ste 212', 'San Antonio', 'Bexar', 'TX', '78217', '2106546281', NULL, '8601 Village Dr Ste 212', 'San Antonio', 'Bexar', 'TX', '78217', '2106546281', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083615827', 0, 'N', 0, '2013-04-17', NULL, NULL, 29.5182, -98.4275, NULL, NULL),
('742083988', 'TX0101033', 'TX0101033', 'TXSATSTD', 'Renal Associates', 'Lisa', 'O', 'Cabrera', 'MD', 'Nephrology', '', '', NULL, 'O', '497 10th St Ste 102', 'Floresville', 'Wilson', 'TX', '78114', '8303931750', NULL, '497 10th St Ste 102', 'Floresville', 'Wilson', 'TX', '78114', '8303931750', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1811962723', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.1502, -98.1628, NULL, NULL),
('742083988', 'TX0101034', 'TX0101034', 'TXSATSTD', 'Renal Associates', 'Lisa', 'O', 'Cabrera', 'MD', 'Nephrology', '', '', NULL, 'O', '4242 E Southcross Blvd Ste 16', 'San Antonio', 'Bexar', 'TX', '78222', '2103597888', NULL, '4242 E Southcross Blvd Ste 16', 'San Antonio', 'Bexar', 'TX', '78222', '2103597888', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1811962723', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.3749, -98.4113, NULL, NULL),
('113676182', 'TX0101035', 'TX0101035', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Elias', 'R', 'Cheleuitte', 'DPM', 'Podiatry', '', '', NULL, 'O', '28580 IH 10 W Ste 3', 'Boerne', 'Kendall', 'TX', '78006', '2102274164', '2102276708', '28580 IH 10 W Ste 3', 'Boerne', 'Kendall', 'TX', '78006', '2102274164', '2102276708', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1972594455', 0, 'N', 0, '2013-06-06', NULL, NULL, 29.7222, -98.6683, 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
('113676182', 'TX0101037', 'TX0101037', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Elias', 'R', 'Cheleuitte', 'DPM', 'Podiatry', '', '', NULL, 'O', '1301 Hospital Blvd', 'Floresville', 'Wilson', 'TX', '78114', '2102274164', '2102276708', '1301 Hospital Blvd', 'Floresville', 'Wilson', 'TX', '78114', '2102274164', '2102276708', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1972594455', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.114, -98.1697, NULL, NULL),
('742317397', 'TX0101040', 'TX0101040', 'TXSATSTD', 'Skinner Clinic', 'Clay', 'R', 'Skinner', 'MD', 'Vascular Surgery', 'General Surgery', NULL, NULL, 'O', '124 Dallas St', 'San Antonio', 'Bexar', 'TX', '78205', '2102241771', NULL, '124 Dallas St', 'San Antonio', '', 'TX', '78205', '', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', NULL, 'HCFA|UB|', '1811001936', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.433, -98.4925, NULL, NULL),
('742143569', 'TX0101043', 'TX0101043', 'TXSATSTD', 'Toyota Family Health Center', 'Jason', 'D', 'Burns', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', NULL, '1 Lone Star Pass Bldg 46', 'San Antonio', 'Bexar', 'TX', '78264', '2102635700', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-22', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1679579874', 0, 'N', 0, '2013-07-29', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0101048', 'TX0101048', 'TXSATSTD', 'South Texas Spinal Clinic', NULL, NULL, 'South Texas Spinal Clinic, PA', NULL, 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2104959047', NULL, NULL, NULL, '', NULL, NULL, '', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000008838', 0, 'Y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0101049', 'TX0101049', 'TXSATSTD', 'South Texas Spinal Clinic', 'Paul', 'T', 'Geibel', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2104959047', NULL, 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2104959047', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1265431621', 0, 'Y', 0, '2014-04-07', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0101050', 'TX0101050', 'TXSATSTD', 'South Texas Spinal Clinic', 'Charles', 'S', 'Pipkin', 'MD', 'Orthopaedic Surgery', '', '', NULL, 'B', 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2104959047', NULL, 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2104959047', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1780683144', 0, 'Y', 0, '2014-02-03', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0101052', 'TX0101052', 'TXSATSTD', 'South Texas Spinal Clinic', 'Gilbert', 'R', 'Meadows', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2104959047', NULL, 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2104959047', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174522536', 0, 'Y', 0, '2014-03-21', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0101053', 'TX0101053', 'TXSATSTD', 'South Texas Spinal Clinic', 'James', 'W', 'Simmons, III', 'DO', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2104959047', NULL, 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2104959047', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000008723', 0, 'Y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0101054', 'TX0101054', 'TXSATSTD', 'South Texas Spinal Clinic', 'Jerjis', 'J', 'Denno', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2106146432', NULL, 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2106146432', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1033186515', 0, 'Y', 0, '2013-07-10', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0101055', 'TX0101055', 'TXSATSTD', 'South Texas Spinal Clinic', 'Michael', 'David', 'Dennis', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2106146432', NULL, 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2106146432', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1447259809', 0, 'Y', 0, '2013-07-16', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0201057', 'TX0201057', 'TXSATSTD', 'South Texas Spinal Clinic', 'David', 'A', 'Roberts', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2106146432', NULL, 'PO Box 120037', 'San Antonio', 'Bexar', 'TX', '78212', '2106146432', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1487653705', 0, 'Y', 0, '2014-03-18', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0101058', 'TX0101058', 'TXSATSTD', 'South Texas Spinal Clinic', 'Paul', 'T', 'Geibel', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '18626 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '8002807977', NULL, '18626 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '8002807977', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1265431621', 0, 'N', 0, '2014-04-07', NULL, NULL, 29.6137, -98.4785, NULL, NULL),
('742503534', 'TX0101059', 'TX0101059', 'TXSATSTD', 'South Texas Spinal Clinic', 'Paul', 'T', 'Geibel', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '12709 Toepperwein Rd Ste 212', 'San Antonio', 'Bexar', 'TX', '78233', '2104959047', '          ', '12709 Toepperwein Rd Ste 212', 'San Antonio', 'Bexar', 'TX', '78233', '2104959047', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1265431621', 0, 'N', 0, '2014-04-07', NULL, NULL, 29.5535, -98.3472, NULL, NULL),
('742503534', 'TX0101060', 'TX0101060', 'TXSATSTD', 'South Texas Spinal Clinic', 'Paul', 'T', 'Geibel', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '861 Landa St', 'New Braunfels', 'Comal', 'TX', '78130', '2104959047', NULL, '861 Landa St', 'New Braunfels', 'Comal', 'TX', '78130', '2104959047', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1265431621', 0, 'N', 0, '2014-04-07', NULL, NULL, 29.6992, -98.1487, NULL, NULL),
('742503534', 'TX0101061', 'TX0101061', 'TXSATSTD', 'South Texas Spinal Clinic', 'Paul', 'T', 'Geibel', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2003 A Pkwy', 'San Marcos', 'Hays', 'TX', '78666', '2104959047', NULL, '2003 A Pkwy', 'San Marcos', 'Hays', 'TX', '78666', '2104959047', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1265431621', 0, 'Y', 0, '2014-04-07', NULL, NULL, 29.8842, -97.9374, NULL, NULL),
('742503534', 'TX0101062', 'TX0101062', 'TXSATSTD', 'South Texas Spinal Clinic', 'Charles', 'S', 'Pipkin', 'MD', 'Orthopaedic Surgery', '', '', NULL, 'O', '12709 Toepperwein Rd Ste 302', 'San Antonio', 'Bexar', 'TX', '78233', '2104959047', NULL, '12709 Toepperwein Rd Ste 302', 'San Antonio', 'Bexar', 'TX', '78233', '2104959047', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1780683144', 0, 'N', 0, '2014-02-03', NULL, NULL, 29.5535, -98.3472, NULL, NULL),
('742503534', 'TX0101063', 'TX0101063', 'TXSATSTD', 'South Texas Spinal Clinic', 'Charles', 'S', 'Pipkin', 'MD', 'Orthopaedic Surgery', '', '', NULL, 'O', '861 Landa St', 'New Braunfels', 'Comal', 'TX', '78130', '2104959047', NULL, '861 Landa St', 'New Braunfels', 'Comal', 'TX', '78130', '2104959047', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1780683144', 0, 'N', 0, '2014-02-03', NULL, NULL, 29.6992, -98.1487, NULL, NULL),
('742503534', 'TX0101064', 'TX0101064', 'TXSATSTD', 'South Texas Spinal Clinic', 'Charles', 'S', 'Pipkin', 'MD', 'Orthopaedic Surgery', '', '', NULL, 'O', '18626 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '8002807977', NULL, '18626 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '8002807977', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1780683144', 0, 'N', 0, '2014-02-03', NULL, NULL, 29.6137, -98.4785, NULL, NULL),
('742503534', 'TX0101065', 'TX0101065', 'TXSATSTD', 'South Texas Spinal Clinic', 'Charles', 'S', 'Pipkin', 'MD', 'Orthopaedic Surgery', '', '', NULL, 'O', '2003 A Pkwy', 'San Marcos', 'Hays', 'TX', '78666', '2104959047', NULL, '2003 A Pkwy', 'San Marcos', 'Hays', 'TX', '78666', '2104959047', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1780683144', 0, 'Y', 0, '2014-02-03', NULL, NULL, 29.8842, -97.9374, NULL, NULL),
('742503534', 'TX0101068', 'TX0101068', 'TXSATSTD', 'South Texas Spinal Clinic', 'Gilbert', 'R', 'Meadows', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '18626 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '8002807977', NULL, '18626 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '8002807977', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174522536', 0, 'N', 0, '2014-03-21', NULL, NULL, 29.6137, -98.4785, NULL, NULL),
('742503534', 'TX0101069', 'TX0101069', 'TXSATSTD', 'South Texas Spinal Clinic', 'James', 'W', 'Simmons, III', 'DO', 'Orthopedic Surgery', '', '', NULL, 'O', '18626 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '8002807977', NULL, '18626 Hardy Oak Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '8002807977', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000008723', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.6137, -98.4785, NULL, NULL),
('742503534', 'TX0101070', 'TX0101070', 'TXSATSTD', 'South Texas Spinal Clinic', 'Jerjis', 'J', 'Denno', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '5282 Medical Dr Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '8009241455', NULL, '5282 Medical Dr Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '8009241455', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1033186515', 0, 'N', 0, '2013-07-10', NULL, NULL, 29.5095, -98.5891, NULL, NULL),
('742503534', 'TX0101071', 'TX0101071', 'TXSATSTD', 'South Texas Spinal Clinic', 'Jerjis', 'J', 'Denno', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1406 E Houston St', 'Beeville', 'Bee', 'TX', '78102', '2106146432', NULL, '1406 E Houston St', 'Beeville', 'Bee', 'TX', '78102', '2106146432', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-24', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1033186515', 0, 'N', 0, '2013-07-10', NULL, NULL, 0, 0, NULL, NULL),
('742503534', 'TX0101072', 'TX0101072', 'TXSATSTD', 'South Texas Spinal Clinic', 'Michael', 'David', 'Dennis', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '5282 Medical Dr Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '8009241455', NULL, '5282 Medical Dr Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '8009241455', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1447259809', 0, 'N', 0, '2013-07-16', NULL, NULL, 29.5095, -98.5891, NULL, NULL),
('742503534', 'TX0101073', 'TX0101073', 'TXSATSTD', 'South Texas Spinal Clinic', 'Michael', 'David', 'Dennis', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '6801 McPherson Rd Ste 219', 'Laredo', 'Webb', 'TX', '78041', '2106146432', NULL, '6801 McPherson Rd Ste 219', 'Laredo', 'Webb', 'TX', '78041', '2106146432', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1447259809', 0, 'Y', 0, '2013-07-16', NULL, NULL, 27.5649, -99.4733, NULL, NULL),
('742503534', 'TX0101077', 'TX0101077', 'TXSATSTD', 'South Texas Spinal Clinic', 'David', 'A', 'Roberts', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '5282 Medical Dr Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '8009241455', NULL, '5282 Medical Dr Ste 200', 'San Antonio', 'Bexar', 'TX', '78229', '8009241455', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1487653705', 0, 'N', 0, '2014-03-18', NULL, NULL, 29.5095, -98.5891, NULL, NULL),
('742503534', 'TX0101078', 'TX0101078', 'TXSATSTD', 'South Texas Spinal Clinic', 'David', 'A', 'Roberts', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '204 W Windcrest', 'Fredericksburg', 'Gillespie', 'TX', '78624', '2106146432', NULL, '204 W Windcrest', 'Fredericksburg', 'Gillespie', 'TX', '78624', '2106146432', '', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1487653705', 0, 'Y', 0, '2014-03-18', NULL, NULL, 30.264, -98.8788, NULL, NULL),
('743015679', 'TX0101083', 'TX0101083', 'TXSATSTD', 'Admit PA', 'George', '', 'Wilcox', 'DO', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009615', 0, 'N', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101084', 'TX0101084', 'TXSATSTD', 'Admit PA', 'George', '', 'Wilcox', 'DO', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009615', 0, 'Y', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101085', 'TX0101085', 'TXSATSTD', 'Admit PA', 'Brian', '', 'Treuhaft', 'DO', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009175', 0, 'N', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101086', 'TX0101086', 'TXSATSTD', 'Admit PA', 'Brian', '', 'Treuhaft', 'DO', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009175', 0, 'Y', 0, '2013-05-28', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101087', 'TX0101087', 'TXSATSTD', 'Admit PA', 'Mitchell', '', 'Curry', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005859', 0, 'N', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101088', 'TX0101088', 'TXSATSTD', 'Admit PA', 'Mitchell', '', 'Curry', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005859', 0, 'Y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101089', 'TX0101089', 'TXSATSTD', 'Admit PA', 'Michael', '', 'Lozano', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007344', 0, 'N', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101090', 'TX0101090', 'TXSATSTD', 'Admit PA', 'Michael', '', 'Lozano', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007344', 0, 'Y', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101091', 'TX0101091', 'TXSATSTD', 'Admit PA', 'Dominic', '', 'Meza', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007588', 0, 'N', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101092', 'TX0101092', 'TXSATSTD', 'Admit PA', 'Dominic', '', 'Meza', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007588', 0, 'Y', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101093', 'TX0101093', 'TXSATSTD', 'Admit PA', 'William', '', 'Mallott', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007408', 0, 'N', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101094', 'TX0101094', 'TXSATSTD', 'Admit PA', 'William', '', 'Mallott', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007408', 0, 'Y', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101095', 'TX0101095', 'TXSATSTD', 'Admit PA', 'Minh', '', 'Do', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005996', 0, 'N', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101096', 'TX0101096', 'TXSATSTD', 'Admit PA', 'Minh', '', 'Do', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005996', 0, 'Y', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101097', 'TX0101097', 'TXSATSTD', 'Admit PA', 'Brian', '', 'Gould', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006462', 0, 'N', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101098', 'TX0101098', 'TXSATSTD', 'Admit PA', 'Brian', '', 'Gould', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006462', 0, 'Y', 0, '2012-09-04', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101099', 'TX0101099', 'TXSATSTD', 'Admit PA', 'Vanessa', 'Bernal', 'Smeberg', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008749', 0, 'N', 0, '2013-05-09', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101100', 'TX0101100', 'TXSATSTD', 'Admit PA', 'Vanessa', 'Bernal', 'Smeberg', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008749', 0, 'Y', 0, '2013-05-10', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101101', 'TX0101101', 'TXSATSTD', 'Admit PA', 'Judy', '', 'Shumway', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008711', 0, 'N', 0, '2013-05-09', NULL, NULL, 0, 0, NULL, NULL),
('743015679', 'TX0101102', 'TX0101102', 'TXSATSTD', 'Admit PA', 'Judy', '', 'Shumway', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', NULL, 'PO Box 701154', 'San Antonio', 'Bexar', 'TX', '78270', '2105765299', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008711', 0, 'Y', 0, '2013-05-10', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101103', 'TX0101103', 'TXSATSTD', 'Texas Inpatient Physicians Association', '', '', 'Texas Inpatient Physicians Association', '', 'Internal Medicine', '', '', NULL, 'B', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009038', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101104', 'TX0101104', 'TXSATSTD', 'Texas Inpatient Physicians Association', '', '', 'Texas Inpatient Physicians Association', '', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009038', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101105', 'TX0101105', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Marium', '', 'Steele', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008892', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101106', 'TX0101106', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Marium', '', 'Steele', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008892', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101107', 'TX0101107', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Eduard', 'J', 'Uribe', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009337', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101108', 'TX0101108', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Eduard', 'J', 'Uribe', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009337', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101109', 'TX0101109', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Edward', '', 'Sternaman', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008907', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101110', 'TX0101110', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Edward', '', 'Sternaman', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008907', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101111', 'TX0101111', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Cybele', '', 'Mathai', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007470', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101112', 'TX0101112', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Cybele', '', 'Mathai', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007470', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101113', 'TX0101113', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Felipe', '', 'Navas', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007796', 0, 'N', 0, '2012-10-16', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101114', 'TX0101114', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Felipe', '', 'Navas', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000007796', 0, 'Y', 0, '2012-10-16', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101115', 'TX0101115', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Connor', '', 'Chase', 'MD', 'Internal Medicine', '', '', NULL, 'O', '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', NULL, '18850 Redland Rd', 'San Antonio', 'Bexar', 'TX', '78259', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005653', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('320056334', 'TX0101116', 'TX0101116', 'TXSATSTD', 'Texas Inpatient Physicians Association', 'Connor', '', 'Chase', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', NULL, 'PO Box 701194', 'San Antonio', 'Bexar', 'TX', '78270', '2103840011', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000005653', 0, 'Y', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('742997354', 'TX0101119', 'TX0101119', 'TXSATSTD', 'Texas Plastic Surgery', 'Jaime', 'R', 'Garza', 'MD DDS PA', 'Plastic Surgery', NULL, NULL, NULL, 'O', '21 Spurs Ln Ste 120', 'San Antonio', 'Bexar', 'TX', '78240', '2106160301', NULL, '2829 Babcock', 'San Antonio', '', 'TX', '78229', '', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689678575', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.5267, -98.5922, NULL, NULL),
('200163261', 'TX0101120', 'TX0101120', 'TXSATSTD', 'Daniel Hyun MD', 'Daniel', '', 'Hyun', 'MD', 'Neurology', '', '', NULL, 'O', '315 N San Saba Ste 1110', 'San Antonio', 'Bexar', 'TX', '78207', '2102263326', NULL, '315 N San Saba Ste 1110', 'San Antonio', 'Bexar', 'TX', '78207', '2102263326', '          ', 'TXSURGD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-08', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1902087240', 0, 'N', 0, '2014-03-25', NULL, NULL, 29.4279, -98.5002, NULL, NULL),
('200163261', 'TX0101121', 'TX0101121', 'TXSATSTD', 'Daniel Hyun MD', 'Daniel', '', 'Hyun', 'MD', 'Neurology', '', '', NULL, 'O', '31 Stone Wall Bend', 'San Antonio', 'Bexar', 'TX', '78256', '2102263326', NULL, '31 Stone Wall Bend', 'San Antonio', 'Bexar', 'TX', '78256', '2102263326', '          ', 'TXSURGD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1902087240', 0, 'N', 0, '2014-03-25', NULL, NULL, 0, 0, NULL, NULL),
('742975191', 'TX0101124', 'TX0101124', 'TXSATSTD', 'Yolanda Marcos MD', 'Yolanda', '', 'Marcos', 'MD', 'Internal Medicine', '', '', NULL, 'O', '510 Med Ct Ste 210', 'San Antonio', 'Bexar', 'TX', '78258', '2104944290', NULL, '510 Med Ct Ste 210', 'San Antonio', 'Bexar', 'TX', '78258', '2104944290', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104845445', 0, 'N', 0, '2013-04-17', NULL, NULL, 29.6242, -98.4935, NULL, NULL),
('742975191', 'TX0101125', 'TX0101125', 'TXSATSTD', 'Yolanda Marcos MD', 'Yolanda', '', 'Marcos', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 659506', 'San Antonio', 'Bexar', 'TX', '78265', '2104944290', NULL, 'PO Box 659506', 'San Antonio', 'Bexar', 'TX', '78265', '2104944290', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104845445', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('742145952', 'TX0101126', 'TX0101126', 'TXSATSTD', 'Endocrinology-Nuclear Medicine Associates PA', '', '', 'Endocrinology-Nuclear Medicine Associates PA', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006128', 0, 'Y', 0, '2014-07-08', NULL, NULL, 29.4407, -98.4918, NULL, NULL),
('742145952', 'TX0101127', 'TX0101127', 'TXSATSTD', 'Endocrinology-Nuclear Medicine Associates', 'Richard', 'A', 'Becker', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1306985676', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.4407, -98.4918, NULL, NULL),
('742145952', 'TX0101128', 'TX0101128', 'TXSATSTD', 'Endocrinology-Nuclear Medicine Associates', 'Harry', 'L', 'Uy', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1962541466', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.4407, -98.4918, NULL, NULL),
('742145952', 'TX0101129', 'TX0101129', 'TXSATSTD', 'Endocrinology-Nuclear Medicine Associates', 'Robert ', 'F', 'Dons', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1508905928', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.4407, -98.4918, NULL, NULL),
('742145952', 'TX0101131', 'TX0101131', 'TXSATSTD', 'Endocrinology-Nuclear Medicine Associates', 'Nancy', 'A', 'Lee', 'MD', 'Endocrinology', '', '', NULL, 'O', '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', NULL, '1303 McCullough Ave Ste 374', 'San Antonio', 'Bexar', 'TX', '78212', '2102235483', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1922147271', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.4407, -98.4918, NULL, NULL),
('742625722', 'TX0101151', 'TX0101151', 'TXSATSTD', 'Alamo ENT Associates', 'William', 'W', 'Gordon', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1205844297', 0, 'Y', 0, '2013-04-04', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0101152', 'TX0101152', 'TXSATSTD', 'Alamo ENT Associates', 'Cary', 'E', 'Stratton', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1578571568', 0, 'Y', 0, '2014-07-17', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0101153', 'TX0101153', 'TXSATSTD', 'Alamo ENT Associates', 'Thomas', 'W', 'Nau', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'North East Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1942218938', 0, 'Y', 0, '2013-04-04', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0101154', 'TX0101154', 'TXSATSTD', 'Alamo ENT Associates', 'William', 'C', 'Smith', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336140680', 0, 'Y', 0, '2013-05-28', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0101155', 'TX0101155', 'TXSATSTD', 'Alamo ENT Associates', 'Jeffrey', 'S', 'Rosenbloom', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', '', '', '', 'HCFA|UB|', '1386652378', 0, 'Y', 0, '2014-06-17', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0101156', 'TX0101156', 'TXSATSTD', 'Alamo ENT Associates', 'Charles', 'P', 'Biediger', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033127022', 0, 'Y', 0, '2013-04-04', NULL, NULL, 0, 0, NULL, NULL),
('742625722', 'TX0101157', 'TX0101157', 'TXSATSTD', 'Alamo ENT Associates', 'John', 'D', 'Edwards', 'MD', 'Ear, Nose and Throat', 'Pediatric Ear, Nose and Throat', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336158294', 0, 'Y', 0, '2013-06-27', NULL, NULL, 0, 0, NULL, NULL),
('562613565', 'TX0100571', 'TX0100571', 'TXSATSTD', 'Arthritis Associates', 'Rodolfo', '', 'Molina', 'MD', 'Rheumatology', '', '', NULL, 'O', '4511 Horizon Hill Blvd Ste 150', 'San Antonio', 'Bexar', 'TX', '78229', '2104772626', NULL, '4511 Horizon Hill Blvd Ste 150', 'San Antonio', 'Bexar', 'TX', '78229', '2104772626', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1104895713', 0, 'n', 0, '2012-12-17', NULL, NULL, 29.5178, -98.5579, NULL, NULL),
('562613565', 'TX0100572', 'TX0100572', 'TXSATSTD', 'Arthritis Associates', 'Pendleton', 'B', 'Wickersham', 'MD', 'Rheumatology', '', '', NULL, 'O', '4511 Horizon Hill Blvd Ste 150', 'San Antonio', 'Bexar', 'TX', '78229', '2104772626', NULL, '4511 Horizon Hill Blvd Ste 150', 'San Antonio', 'Bexar', 'TX', '78229', '2104772626', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1053380048', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.5178, -98.5579, NULL, NULL),
('562613565', 'TX0100573', 'TX0100573', 'TXSATSTD', 'Arthritis Associates', 'Matthew', 'E', 'Mosbacker', 'MD', 'Rheumatology', '', '', NULL, 'O', '4511 Horizon Hill Blvd Ste 150', 'San Antonio', 'Bexar', 'TX', '78229', '2104772626', NULL, '4511 Horizon Hill Blvd Ste 150', 'San Antonio', 'Bexar', 'TX', '78229', '2104772626', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1558330530', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.5178, -98.5579, NULL, NULL),
('562613565', 'TX0100574', 'TX0100574', 'TXSATSTD', 'Arthritis Associates', 'Gerald', 'M', 'Rosenberg', 'MD', 'Rheumatology', '', '', NULL, 'O', '4511 Horizon Hill Blvd Ste 150', 'San Antonio', 'Bexar', 'TX', '78229', '2104772626', NULL, '4511 Horizon Hill Blvd Ste 150', 'San Antonio', 'Bexar', 'TX', '78229', '2104772626', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1649249624', 0, 'N', 0, '2013-04-05', NULL, NULL, 29.5178, -98.5579, NULL, NULL),
('743003947', 'TX0200665', 'TX0200665', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Deborah', 'M', 'Egger', 'PA', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669407441', 0, 'Y', 0, '2013-09-26', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0100770', 'TX0100770', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Eloy', '', 'Ochoa', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144209990', 0, 'Y', 0, '2013-07-09', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0200771', 'TX0200771', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Eloy', '', 'Ochoa', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2103965265', NULL, '150 E Sonterra Blvd Ste 300', 'San Antonio', 'Bexar', 'TX', '78258', '2103965265', '', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144209990', 0, 'N', 0, '2013-07-09', NULL, NULL, 29.6162, -98.493, NULL, NULL),
('743003947', 'TX0100772', 'TX0100772', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Eloy', '', 'Ochoa', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2105931440', NULL, '400 Concord Plaza Dr Ste 300', 'San Antonio', 'Bexar', 'TX', '78216', '2105931440', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'Baptist Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144209990', 0, 'N', 0, '2013-07-09', NULL, NULL, 29.5058, -98.4805, NULL, NULL),
('467419903', 'TX0100872', 'TX0100872', 'TXSATSTD', 'James L Vosberg MD', 'James', 'L', 'Vosberg', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5282 Medical Dr Ste 610', 'San Antonio', 'Bexar', 'TX', '78229', '2106158003', NULL, '5282 Medical Dr Ste 610', 'San Antonio', 'Bexar', 'TX', '78229', '2106158003', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235132747', 0, 'N', 0, '2013-04-24', NULL, NULL, 29.5087, -98.5879, NULL, NULL),
('742058140', 'TX0100878', 'TX0100878', 'TXSATSTD', 'Martin J Wiesenthal MD', 'Martin', 'J', 'Wiesenthal', 'MD', 'Internal Medicine', '', '', NULL, 'O', '8038 Wurzbach Rd Ste 320', 'San Antonio', 'Bexar', 'TX', '78229', '2106143365', NULL, '8038 Wurzbach Rd Ste 320', 'San Antonio', 'Bexar', 'TX', '78229', '2106143365', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770664732', 0, 'N', 0, '2013-04-17', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742058140', 'TX0100879', 'TX0100879', 'TXSATSTD', 'Martin J Wiesenthal MD', 'Martin', 'J', 'Wiesenthal', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 66', 'San Antonio', 'Bexar', 'TX', '78229', '2106143365', NULL, 'PO Box 66', 'San Antonio', 'Bexar', 'TX', '78229', '2106143365', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770664732', 0, 'Y', 0, '2013-04-17', NULL, NULL, 0, 0, NULL, NULL),
('742743906', 'TX0100887', 'TX0100887', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'John', 'E', 'Kobert', 'DO', 'Nephrology', '', '', NULL, 'O', '1008 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', '2102289749', '1008 Brooklyn Ave', 'San Antonio', 'Bexar', 'TX', '78215', '2102280743', '2102289749', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'Mission Trail Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376528810', 0, 'N', 0, '2013-05-07', NULL, NULL, 29.4382, -98.4887, NULL, NULL),
('742743906', 'TX0200889', 'TX0200889', 'TXSATSTD', 'San Antonio Kidney Disease Center', 'Steven', 'G', 'Rosenblatt', 'MD', 'Nephrology', '', '', NULL, 'O', '601 31st St', 'Hondo', 'Medina', 'TX', '78861', '2106927228', NULL, '601 31st St', 'Hondo', 'Medina', 'TX', '78861', '2106927228', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1710962279', 0, 'Y', 0, '2013-05-06', NULL, NULL, 29.3359, -99.1344, NULL, NULL),
('742482411', 'TX0200935', 'TX0200935', 'TXSATSTD', 'Vicki Rickerson MD', 'Averess', 'Vicki', 'Rickerson', 'MD', 'Internal Medicine', '', '', NULL, 'O', '8601 Village Dr Ste 100', 'San Antonio', 'Bexar', 'TX', '78217', '2106467227', NULL, '8601 Village Dr Ste 100', 'San Antonio', 'Bexar', 'TX', '78217', '2106467227', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1821018763', 0, 'N', 0, '2013-09-12', NULL, NULL, 29.5182, -98.4275, NULL, NULL),
('743002424', 'TX0200986', 'TX0200986', 'TXSATSTD', 'Leon Springs Pediatrics', 'Leah', '', 'Garguena-Bacuta', 'MD', 'Pediatrics', '', '', NULL, 'O', '24165 IH 10 W Ste 114', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', NULL, '24165 IH 10 W Ste 114', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1679575708', 0, 'N', 0, '2014-06-04', NULL, NULL, 29.6657, -98.6322, 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
('743002424', 'TX0100987', 'TX0100987', 'TXSATSTD', 'Leon Springs Pediatrics', 'David', 'W', 'Popp', 'MD', 'Pediatrics', '', '', NULL, 'O', '24165 IH 10 W Ste 114', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', NULL, '24165 IH 10 W Ste 114', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', '          ', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417941048', 0, 'N', 0, '2013-07-09', NULL, NULL, 29.6657, -98.6322, NULL, NULL),
('743002424', 'TX0100988', 'TX0100988', 'TXSATSTD', 'Leon Springs Pediatrics', 'David', 'W', 'Popp', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 1937', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', NULL, 'PO Box 1937', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417941048', 0, 'Y', 0, '2013-07-09', NULL, NULL, 0, 0, NULL, NULL),
('743002424', 'TX0100989', 'TX0100989', 'TXSATSTD', 'Leon Springs Pediatrics', 'Leah', '', 'Garguena-Bacuta', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 1937', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', NULL, 'PO Box 1937', 'San Antonio', 'Bexar', 'TX', '78257', '2106871543', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1679575708', 0, 'Y', 0, '2014-06-04', NULL, NULL, 0, 0, NULL, NULL),
('742974353', 'TX0100990', 'TX0100990', 'TXSATSTD', 'Robert G Nobles MD', 'Robert', 'G', 'Nobles', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5979 Babcock Rd', 'San Antonio', 'Bexar', 'TX', '78249', '2106905511', '          ', '5979 Babcock Rd', 'San Antonio', 'Bexar', 'TX', '78249', '2106905511', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-04-06', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1467457937', 0, 'N', 0, '2014-04-10', NULL, NULL, 29.53, -98.6032, NULL, NULL),
('742974353', 'TX0100991', 'TX0100991', 'TXSATSTD', 'Robert G Nobles MD', 'Robert', 'G', 'Nobles', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 690547', 'San Antonio', 'Bexar', 'TX', '78249', '2106905511', NULL, 'PO Box 690547', 'San Antonio', 'Bexar', 'TX', '78249', '2106905511', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1467457937', 0, 'Y', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('742957980', 'TX0100992', 'TX0100992', 'TXSATSTD', 'Lawrence A Alder MD', 'Lawrence', 'A', 'Alder', 'MD', 'Internal Medicine', '', '', NULL, 'O', '19260 Stone Oak Pkwy Ste 105', 'San Antonio', 'Bexar', 'TX', '78258', '2104023456', NULL, '19260 Stone Oak Pkwy Ste 105', 'San Antonio', 'Bexar', 'TX', '78258', '2104023456', '          ', 'TXINTB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1023027182', 0, 'N', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742825112', 'TX0100993', 'TX0100993', 'TXSATSTD', 'Patrick H Peters MD', 'Patrick', 'H', 'Peters', 'MD', 'Internal Medicine', '', '', NULL, 'O', '6547 Bandera Rd Ste C', 'San Antonio', 'Bexar', 'TX', '78238', '2105217676', NULL, '6547 Bandera Rd Ste C', 'San Antonio', 'Bexar', 'TX', '78238', '2105217676', '          ', 'TXINTB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1578505731', 0, 'N', 0, '2013-04-17', NULL, NULL, 29.4922, -98.6144, NULL, NULL),
('161630573', 'TX0201033', 'TX0201033', 'TXSATSTD', 'Priority Pediatrics', 'Jeanne', '', 'Lovett', 'MD', 'Pediatrics', '', '', NULL, 'O', '2235 Thousand Oaks Ste 119', 'San Antonio', 'Bexar', 'TX', '78232', '2104907334', NULL, '2235 Thousand Oaks Ste 119', 'San Antonio', 'Bexar', 'TX', '78232', '2104907334', '          ', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1750477386', 0, 'N', 0, '2012-11-27', NULL, NULL, 29.588, -98.4523, NULL, NULL),
('161751617', 'TX0101041', 'TX0101041', 'TXSATSTD', 'Rheumatology Associates of South Texas', 'Thomas', '', 'Rennie', 'MD', 'Rheumatology', '', '', NULL, 'B', 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', NULL, 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000008358', 0, 'Y', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('161751617', 'TX0101042', 'TX0101042', 'TXSATSTD', 'Rheumatology Associates of South Texas', 'Kevin', NULL, 'Kempf', 'MD', 'Rheumatology', NULL, NULL, NULL, 'B', 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', NULL, '19272 Stone Oak Pkwy', 'San Antonio', '', 'TX', '78258', '', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '0000007065', 0, 'Y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('161751617', 'TX0201043', 'TX0201043', 'TXSATSTD', 'Rheumatology Associates of South Texas', 'Everett', '', 'Allen', 'MD', 'Rheumatology', '', '', NULL, 'B', 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', NULL, 'Po Box 823', 'San Antonio', 'Bexar', 'TX', '78293', '2106563926', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609846641', 0, 'Y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('742106698', 'TX0101057', 'TX0101057', 'TXSATSTD', 'San Antonio Internal Medicine Group', 'George', 'B', 'Schneider', 'MD', 'Internal Medicine', '', '', NULL, 'O', '14100 San Pedro Ste 400', 'San Antonio', 'Bexar', 'TX', '78209', '2104949162', NULL, '14100 San Pedro Ste 400', 'San Antonio', 'Bexar', 'TX', '78209', '2104949162', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-03-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1316932650', 0, 'N', 0, '2013-03-20', NULL, NULL, 0, 0, NULL, NULL),
('742106698', 'TX0201064', 'TX0201064', 'TXSATSTD', 'San Antonio Internal Medicine Group', 'George', 'B', 'Schneider', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1303 McCullough Ave Ste 560', 'San Antonio', 'Bexar', 'TX', '78212', '2102239617', NULL, '1303 McCullough Ave Ste 560', 'San Antonio', 'Bexar', 'TX', '78212', '2102239617', '          ', 'TXINT', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-03-19', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1316932650', 0, 'N', 0, '2013-03-20', NULL, NULL, 29.4412, -98.4924, NULL, NULL),
('742625722', 'TX0201065', 'TX0201065', 'TXSATSTD', 'Alamo ENT Associates', 'Benjamin', 'D', 'Webb', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '7940 Floyd Curl Dr Ste 400', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', NULL, '7940 Floyd Curl Dr Ste 400', 'San Antonio', 'Bexar', 'TX', '78229', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'North East Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1487873329', 0, 'N', 0, '2012-12-20', NULL, NULL, 29.512, -98.5761, NULL, NULL),
('742625722', 'TX0101066', 'TX0101066', 'TXSATSTD', 'Alamo ENT Associates', 'Benjamin', 'D', 'Webb', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78299', '2106160096', NULL, 'PO Box 2679', 'San Antonio', 'Bexar', 'TX', '78299', '2106160096', '', 'TXSURGB', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', 'North East Baptist Hospital', NULL, NULL, 'HCFA|UB|', '1487873329', 0, 'Y', 0, '2012-12-20', NULL, NULL, 0, 0, NULL, NULL),
('742719352', 'TX0101294', 'TX0101294', 'TXSATSTD', 'Urology of San Antonio', 'Kenneth', 'J', 'Stallman', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 125', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', '7909 Fredericksburg Rd Ste 125', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1871575100', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('742719352', 'TX0101296', 'TX0101296', 'TXSATSTD', 'Urology of San Antonio', 'Kurt', 'G', 'Meissner', 'MD', 'Urology', '', '', NULL, 'O', '7909 Fredericksburg Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', '7909 Fredericksburg Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2106144544', '2106174104', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164427449', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.511, -98.5673, NULL, NULL),
('742143569', 'TX0101384', 'TX0101384', 'TXSATSTD', 'Medical Center Ophthalmology Associates', 'Scott', 'A', 'Thomas', 'MD', 'Ophthalmology', '', '', NULL, 'O', '9157 Huebner Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106972020', NULL, '9157 Huebner Rd', 'San Antonio', 'Bexar', 'TX', '78240', '2106972020', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-09-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710033394', 0, 'N', 0, '2014-01-31', NULL, NULL, 29.5286, -98.5961, NULL, NULL),
('205978580', 'TX0101694', 'TX0101694', 'TXSATSTD', 'Alamo Nephrology Associates', 'Naushad', '', 'Zafar', 'MD', 'Nephrology', NULL, NULL, NULL, 'O', '7940 Floyd Curl Dr Ste 260', 'San Antonio', 'Bexar', 'TX', '78229', '2106147900', NULL, '7940 Floyd Curl Dr Ste 260', 'San Antonio', 'Bexar', 'TX', '78229', '2106147900', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-08-31', 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497813331', 0, 'N', 0, '2013-09-24', NULL, NULL, 29.5117, -98.5756, NULL, NULL),
('113676182', 'TX0101700', 'TX0101700', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Michael', 'L', 'Dempsey', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 1277', 'San Antonio', 'Bexar', 'TX', '78295', '2105459100', NULL, 'PO Box 1277', 'San Antonio', 'Bexar', 'TX', '78295', '2105459100', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-23', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1003886789', 0, 'Y', 0, '2013-05-23', NULL, NULL, 0, 0, NULL, NULL),
('113676182', 'TX0101836', 'TX0101836', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Robert', 'L', 'Castillo', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 1277', 'San Antonio', 'Bexar', 'TX', '78295', '2105459100', NULL, 'PO Box 1277', 'San Antonio', 'Bexar', 'TX', '78295', '2105459100', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1497771166', 0, 'Y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('113676182', 'TX0101837', 'TX0101837', 'TXSATSTD', 'The Podiatry Group of South Texas', 'Robert', 'L', 'Castillo', 'DPM', 'Podiatry', '', '', NULL, 'O', '19272 Stone Oak Pkwy Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2104910606', NULL, '19272 Stone Oak Pkwy Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2104910606', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1497771166', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.63, -98.4952, NULL, NULL),
('742938281', 'TX0101944', 'TX0101944', 'TXSATSTD', 'Arnulfo R Garza-Vale MD', 'Arnulfo', 'R', 'Garza-Vale', 'MD', 'Neurosurgery', '', '', NULL, 'O', '9480 Huebner Rd Ste 320', 'San Antonio', 'Bexar', 'TX', '78240', '2106160606', NULL, '9480 Huebner Rd Ste 320', 'San Antonio', 'Bexar', 'TX', '78240', '2106160606', '          ', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-24', 0, 0, 0, 'St Lukes Baptist Hospital', '', '', '', 'HCFA|UB|', '1295717635', 0, 'N', 0, '2013-04-24', NULL, NULL, 0, 0, NULL, NULL),
('742478680', 'TX0102011', 'TX0102011', 'TXSATSTD', 'Night and Day Pediatrics', 'Deepali', 'J', 'Dubal', 'MD', 'Pediatrics', '', '', NULL, 'O', '502 Madison Oak Dr Ste 340', 'San Antonio', 'Bexar', 'TX', '78258', '2104955552', NULL, '502 Madison Oak Dr Ste 340', 'San Antonio', 'Bexar', 'TX', '78258', '2104955552', '          ', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598959447', 0, 'N', 0, '2013-08-28', NULL, NULL, 29.6202, -98.49, NULL, NULL),
('742478680', 'TX0102012', 'TX0102012', 'TXSATSTD', 'Ostrower Nieheisel & Davis MD', 'Deepali', 'J', 'Dubal', 'MD', 'Pediatrics', '', '', NULL, 'B', '4499 Medical Dr Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2104955552', NULL, '4499 Medical Dr Ste 280', 'San Antonio', 'Bexar', 'TX', '78229', '2104955552', '          ', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598959447', 0, 'Y', 0, '2013-08-28', NULL, NULL, 29.5105, -98.5737, NULL, NULL),
('742721916', 'TX0102125', 'TX0102125', 'TXSATSTD', 'Guadalupe Valley Neurology', 'Praveen', 'K', 'Thangada', 'MD', 'Neurology', '', '', NULL, 'O', '634 E Court St', 'Seguin', 'Guadalupe', 'TX', '78155', '8303031819', NULL, '634 E Court St', 'Seguin', 'Guadalupe', 'TX', '78155', '8303031819', '', 'TXSURGD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194816579', 0, 'n', 0, '2013-09-13', NULL, NULL, 29.569, -97.9591, NULL, NULL),
('742721916', 'TX0102126', 'TX0102126', 'TXSATSTD', 'Guadalupe Valley Neurology', 'Praveen', 'K', 'Thangada', 'MD', 'Neurology', '', '', NULL, 'O', '1935 NE Loop 410 Ste 164', 'San Antonio', 'Bexar', 'TX', '78217', '8303031819', NULL, '1935 NE Loop 410 Ste 164', 'San Antonio', 'Bexar', 'TX', '78217', '8303031819', '          ', 'TXSURGD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-09-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194816579', 0, 'N', 0, '2013-09-13', NULL, NULL, 29.517, -98.4316, NULL, NULL),
('742721916', 'TX0102127', 'TX0102127', 'TXSATSTD', 'Guadalupe Valley Neurology', 'Praveen', 'K', 'Thangada', 'MD', 'Neurology', '', '', NULL, 'O', '130 Hays', 'Luling', 'Caldwell', 'TX', '78648', '8303031819', NULL, '130 Hays', 'Luling', 'Caldwell', 'TX', '78648', '8303031819', '          ', 'TXSURGD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-09-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194816579', 0, 'Y', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
('742721916', 'TX0102128', 'TX0102128', 'TXSATSTD', 'Guadalupe Valley Neurology', 'Praveen', 'K', 'Thangada', 'MD', 'Neurology', '', '', NULL, 'O', '1901 Hwy 97 E Ste 200', 'Jourdanton', 'Atascosa', 'TX', '78026', '8303031819', NULL, '1901 Hwy 97 E Ste 200', 'Jourdanton', 'Atascosa', 'TX', '78026', '8303031819', '          ', 'TXSURGD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-09-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194816579', 0, 'Y', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
('742721916', 'TX0102129', 'TX0102129', 'TXSATSTD', 'Guadalupe Valley Neurology', 'Praveen', 'K', 'Thangada', 'MD', 'Neurology', '', '', NULL, 'O', '1110 Sarah Dewitt Dr', 'Gonzales', 'Gonzales', 'TX', '78629', '8303031819', NULL, '1110 Sarah Dewitt Dr', 'Gonzales', 'Gonzales', 'TX', '78629', '8303031819', '          ', 'TXSURGD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-09-13', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194816579', 0, 'Y', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
('742721916', 'TX0102130', 'TX0102130', 'TXSATSTD', 'Guadalupe Valley Neurology', 'Praveen', 'K', 'Thangada', 'MD', 'Neurology', '', '', NULL, 'O', '301 S Hillside Ste 10', 'Beeville', 'Bee', 'TX', '78102', '8303031819', NULL, '301 S Hillside Ste 10', 'Beeville', 'Bee', 'TX', '78102', '8303031819', '          ', 'TXSURGD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194816579', 0, 'N', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
('742721916', 'TX0102131', 'TX0102131', 'TXSATSTD', 'Guadalupe Valley Neurology', 'Praveen', 'K', 'Thangada', 'MD', 'Neurology', '', '', NULL, 'O', '497 10th St Ste 102', 'Floresville', 'Wilson', 'TX', '78114', '8303031819', NULL, '497 10th St Ste 102', 'Floresville', 'Wilson', 'TX', '78114', '8303031819', '          ', 'TXSURGD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-04-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194816579', 0, 'N', 0, '2013-09-13', NULL, NULL, 29.1502, -98.1628, NULL, NULL),
('742997354', 'TX0102146', 'TX0102146', 'TXSATSTD', 'Texas Plastic Surgery', 'Jaime', 'R', 'Garza', 'MD DDS PA', 'Plastic Surgery', NULL, NULL, NULL, 'B', 'PO Box 1547', 'San Antonio', 'Bexar', 'TX', '78296', '2106160301', NULL, 'PO Box 1547', 'San Antonio', '', 'TX', '78296', '', '', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689678575', 0, 'Y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
('742783832', 'TX0102214', 'TX0102214', 'TXSATSTD', 'South Texas Neurosurgical Associates', 'Holger', '', 'Skerhut', 'MD', 'Neurosurgery', '', '', NULL, 'O', '1935 NE Loop 410 Ste 164', 'San Antonio', 'Bexar', 'TX', '78217', '2106509022', '2106500254', '1935 NE Loop 410 Ste 164', 'San Antonio', 'Bexar', 'TX', '78217', '2106509022', '2106500254', 'TXNEURO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North East Baptist Hospital', '', '', '', 'HCFA|UB|', '1447298591', 0, 'n', 0, '2013-01-24', NULL, NULL, 29.5164, -98.4323, NULL, NULL),
('205764098', 'TX0102216', 'TX0102216', 'TXSATSTD', 'Boerne Pediarics', 'Anne', 'D', 'Logan', 'MD', 'Pediatrics', '', '', NULL, 'O', '124 E Bandera Rd Ste 304', 'Boerne', 'Kendall', 'TX', '78006', '8308165055', NULL, '124 E Bandera Rd Ste 304', 'Boerne', 'Kendall', 'TX', '78006', '8308165055', '', 'TXPED', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1851386544', 0, 'N', 0, '2012-08-20', NULL, NULL, 29.7804, -98.7283, NULL, NULL),
('742355770', 'TX0102254', 'TX0102254', 'TXSATSTD', 'Carey L Britt MD', 'Carey', 'L', 'Britt', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '2829 Babcock Rd Ste 129', 'San Antonio', 'Bexar', 'TX', '78229', '2106160718', '2106158469', '2829 Babcock Rd Ste 129', 'San Antonio', 'Bexar', 'TX', '78229', '2106160718', '2106158469', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1376530675', 0, 'N', 0, '2013-05-06', NULL, NULL, 29.5129, -98.5916, NULL, NULL),
('742355770', 'TX0102256', 'TX0102256', 'TXSATSTD', 'Carey L Britt MD', 'Carey', 'L', 'Britt', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 90074', 'San Antonio', 'Bexar', 'TX', '78209', '2106550848', NULL, 'PO Box 90074', 'San Antonio', 'Bexar', 'TX', '78209', '2106550848', '          ', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1376530675', 0, 'Y', 0, '2013-05-06', NULL, NULL, 0, 0, NULL, NULL),
('743003947', 'TX0102524', 'TX0102524', 'TXSATSTD', 'The San Antonio Orthopaedic Group', 'Melissa', 'G', 'Hernandez', 'FNP', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', NULL, 'PO Box 2516', 'San Antonio', 'Bexar', 'TX', '78258', '8004454263', '          ', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000006687', 0, 'Y', 0, '2013-05-28', NULL, NULL, 0, 0, NULL, NULL),
('711016940', 'TX0103213', 'TX0103213', 'TXSATSTD', 'Arthur Rosenthal MD', 'Arthur', '', 'Rosenthal', 'MD', 'General Surgery', '', '', NULL, 'O', '8042 Wurzbach Rd Ste 480', 'San Antonio', 'Bexar', 'TX', '78229', '2106160657', NULL, '8042 Wurzbach Rd Ste 480', 'San Antonio', 'Bexar', 'TX', '78229', '2106160657', '          ', 'TXSURGA', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1154393247', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.514, -98.5778, NULL, NULL),
('742719352', 'TX0103218', 'TX0103218', 'TXSATSTD', 'Urology of San Antonio', 'Christopher', 'W', 'Graham', 'MD', 'Urology', '', '', NULL, 'O', '255 E Sonterra Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2105810376', '2105810382', '255 E Sonterra Ste 200', 'San Antonio', 'Bexar', 'TX', '78258', '2105810376', '2105810382', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1861472961', 0, 'N', 0, '2014-01-24', NULL, NULL, 29.6164, -98.4911, NULL, NULL),
('742719352', 'TX0103219', 'TX0103219', 'TXSATSTD', 'Urology of San Antonio', 'Patricia', 'P', 'Cecconi', 'MD', 'Urology', '', '', NULL, 'O', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', '414 Navarro Ste 900', 'San Antonio', 'Bexar', 'TX', '78205', '2104747020', '2102262192', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Mission Trail Baptist Hospital', '', '', '', 'HCFA|UB|', '1558399816', 0, 'N', 0, '2014-04-11', NULL, NULL, 29.4254, -98.4897, NULL, NULL),
('742719352', 'TX0103220', 'TX0103220', 'TXSATSTD', 'Urology of San Antonio', 'Patricia', 'P', 'Cecconi', 'MD', 'Urology', '', '', NULL, 'O', '4212 E Southcross Blvd Ste 125', 'San Antonio', 'Bexar', 'TX', '78222', '2103376228', '2103046476', '4212 E Southcross Blvd Ste 125', 'San Antonio', 'Bexar', 'TX', '78222', '2103376228', '2103046476', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2014-04-08', 0, 0, 0, 'Mission Trail Baptist Hospital', '', '', '', 'HCFA|UB|', '1558399816', 0, 'N', 0, '2014-04-11', NULL, NULL, 29.3748, -98.412, NULL, NULL),
('742796322', 'TX0103267', 'TX0103267', 'TXSATSTD', 'Southwest Allergy & Asthma Clinic', 'Bruce', 'G', 'Martin', 'DO', 'Allergy and Immunology', '', '', NULL, 'O', '7711 Louis Pasteur Dr Ste 901/905', 'San Antonio', 'Bexar', 'TX', '78229', '2106160690', NULL, '7711 Louis Pasteur Dr Ste 901/905', 'San Antonio', 'Bexar', 'TX', '78229', '2106160690', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1326087081', 0, 'N', 0, '2013-10-07', NULL, NULL, 29.5088, -98.57, NULL, NULL),
('742796322', 'TX0103268', 'TX0103268', 'TXSATSTD', 'Southwest Allergy & Asthma Clinic', 'Bruce', 'G', 'Martin', 'DO', 'Allergy and Immunology', '', '', NULL, 'O', '155 Sonterra Blvd Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2104940690', NULL, '155 Sonterra Blvd Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2104940690', '', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1326087081', 0, 'n', 0, '2013-05-01', NULL, NULL, 29.6164, -98.493, NULL, NULL),
('742796322', 'TX0103269', 'TX0103269', 'TXSATSTD', 'Southwest Allergy & Asthma Clinic', 'Bruce', 'G', 'Martin', 'DO', 'Allergy and Immunology', '', '', NULL, 'O', '3903 Wiseman Blvd Ste 202', 'San Antonio', 'Bexar', 'TX', '78257', '2107670690', NULL, '3903 Wiseman Blvd Ste 202', 'San Antonio', 'Bexar', 'TX', '78257', '2107670690', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1326087081', 0, 'N', 0, '2013-10-07', NULL, NULL, 29.4763, -98.6953, NULL, NULL),
('820391200', 'ID0104420', 'ID0104420', 'IDBOISTD', 'Neurological Associates', '', '', 'Neurological Associates', 'GROUP', 'Neurology', '', '', NULL, 'B', '3875 E Overland Rd Ste 203', 'Meridian', 'Ada', 'ID', '83642', '2083433976', '          ', '3875 E Overland Rd Ste 203', 'Meridian', 'Ada', 'ID', '83642', '2083433976', '          ', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', '2014-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1912963372', 0, 'N', 0, '2014-04-25', NULL, NULL, 43.5898, -116.346, NULL, NULL),
('820391200', 'ID0104421', 'ID0104421', 'IDBOISTD', 'Neurological Associates', 'Martha', 'A', 'Cline', 'MD', 'Neurology', '', '', NULL, 'O', '3875 E Overland Rd Ste 203', 'Meridian', 'Ada', 'ID', '83642', '2083433976', '2083339942', '3875 E Overland Rd Ste 203', 'Meridian', 'Ada', 'ID', '83642', '2083433976', '2083339942', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', '2014-04-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1043249964', 0, 'N', 0, '2014-04-25', NULL, NULL, 43.5904, -116.345, NULL, NULL),
('820391200', 'ID0104422', 'ID0104422', 'IDBOISTD', 'Neurological Associates', 'Stephen', 'W', 'Asher', 'MD', 'Neurology', '', '', NULL, 'O', '3875 E Overland Rd Ste 203', 'Meridian', 'Ada', 'ID', '83642', '2083433976', '2083339942', '3875 E Overland Rd Ste 203', 'Meridian', 'Ada', 'ID', '83642', '2083433976', '2083339942', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', '2014-04-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1871523373', 0, 'N', 0, '2014-04-25', NULL, NULL, 43.5904, -116.345, NULL, NULL),
('820391200', 'ID0104423', 'ID0104423', 'IDBOISTD', 'Neurological Associates', 'Allen', 'C', 'Han', 'MD', 'Neurology', '', '', NULL, 'O', '3875 E Overland Rd Ste 203', 'Meridian', 'Ada', 'ID', '83642', '2083433976', '          ', '3875 E Overland Rd Ste 203', 'Meridian', 'Ada', 'ID', '83642', '2083433976', '          ', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', '2014-04-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1801825724', 0, 'N', 0, '2014-04-25', NULL, NULL, 43.5904, -116.345, NULL, NULL),
('203129832', 'ID0104424', 'ID0104424', 'IDBOISTD', 'Idaho Minor Emergency and Family Practice', 'Raymond', 'P', 'Hooft', 'MD', 'Family Practice', '', '', NULL, 'O', '3041 E Copper Pointe Dr', 'Meridian', 'Ada', 'ID', '83642', '2085144400', '2085144404', '3041 E Copper Pointe Dr', 'Meridian', 'Ada', 'ID', '83642', '2085144400', '2085144404', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114974326', 0, 'N', 0, '2014-03-03', NULL, NULL, 43.5838, -116.356, NULL, NULL),
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('820477852', 'ID0104635', 'ID0104635', 'IDBOISTD', 'Saint Alphonsus Medical Group Cherry Lane', 'Jennifer', '', 'Hale', 'DO', 'Sleep Medicine', '', '', NULL, 'o', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2012-08-20', '2012-12-12', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1831143338', 0, 'N', 0, '2014-05-06', NULL, NULL, 43.6188, -116.431, NULL, NULL),
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('820445140', 'ID0104933', 'ID0104933', 'IDBOISTD', 'The Eye Associates', 'Gregory', 'J', 'Kent', 'MD', 'Ophthalmology', '', '', NULL, 'O', '901 N Curtis Rd Ste 302', 'Boise', 'Ada', 'ID', '83706', '2083425151', NULL, '901 N Curtis Rd Ste 302', 'Boise', 'Ada', 'ID', '83706', '2083425151', '          ', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', '2013-06-03', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1891868006', 0, 'N', 0, '2013-07-31', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('460500210', 'ID0104694', 'ID0104694', 'IDBOISTD', 'Saint Alphonsus Regional Medical Center - Trauma Coverage', 'Reese', 'A', 'Verner', 'MD', 'General Surgery', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', 'IDSAMG1', NULL, '', '0.00', '10.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1427085281', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'ID0104724', 'ID0104724', 'IDBOISTD', 'Saint Alphonsus Medical Group Hospitalist Boise', 'Jeffery', 'S', 'Dzieczkowski', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1578502415', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'ID0104718', 'ID0104718', 'IDBOISTD', 'Saint Alphonsus Medical Group Hosptialist Boise', 'Robert', 'L', 'Petersen', 'MD', 'Hospitalist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', 'IDSAMG1', '', '', '0.00', '10.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1043229685', 0, 'Y', 0, '2013-07-03', NULL, NULL, 43.6145, -116.254, NULL, NULL),
('820200895', 'ID0104729', 'ID0104729', 'IDBOISTD', 'Saint Alphonsus Medical Group Hospitalist Boise', 'John', 'E', 'Guicheteau', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1902840473', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'ID0104712', 'ID0104712', 'IDBOISTD', 'Saint Alphonsus Medical Group Hospitalist Boise', 'Stephen', 'J', 'Focht', 'MD', 'Hospitalist', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSAMG1', '', '', '0.00', '10.00', '0.00', 6, '2012-08-20', '2013-03-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1043288004', 0, 'Y', 0, '2013-02-21', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'ID0104733', 'ID0104733', 'IDBOISTD', 'Saint Alphonsus Medical Group Hosptialist Boise', 'John', 'W', 'Mahan', 'MD', 'Hospitalist', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2012-08-20', '2012-11-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1346241296', 0, 'Y', 0, '2013-04-03', NULL, NULL, 43.6127, -116.254, NULL, NULL),
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('820200895', 'ID0104731', 'ID0104731', 'IDBOISTD', 'Saint Alphonsus Medical Group Hosptialist Boise', 'Alan', 'M', 'Maderious', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1134162530', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'ID0104711', 'ID0104711', 'IDBOISTD', 'Saint Alphonsus Medical Group Hospitalist Boise', 'Clive', 'R', 'Cooper', 'MD', 'Hospitalist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', 'IDSAMG1', '', '', '0.00', '10.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1962446104', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6145, -116.254, NULL, NULL),
('680569751', 'ID0104959', 'ID0104959', 'IDBOISTD', 'Davis Family Medicine', 'Ashley', 'A', 'Davis', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 44613', 'Boise', 'Ada', 'ID', '83711', '2084299100', NULL, 'PO Box 44613', 'Boise', 'Ada', 'ID', '83711', '2084299100', '', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1437180841', 0, 'Y', 0, '2012-08-20', NULL, NULL, 0, 0, NULL, NULL),
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('820477852', 'ID0104645', 'ID0104645', 'IDBOISTD', 'Saint Alphonsus Medical Group McMillan Family Medicine', 'Robert', 'K', 'Perko', 'MD', 'Family Practice', '', '', NULL, 'o', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSAMG2', '', '', '0.00', '10.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1043261803', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6484, -116.337, NULL, NULL),
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('204157017', 'ID0105021', 'ID0105021', 'IDBOISTD', 'Jensen Eye Associates', 'Peter', 'E', 'Jensen', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1615 12th Ave Rd Ste A', 'Nampa', 'Canyon', 'ID', '83686', '2084673271', NULL, '1615 12th Ave Rd Ste A', 'Nampa', 'Canyon', 'ID', '83686', '2084673271', '', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1285602581', 0, 'n', 0, '2014-03-20', NULL, NULL, 43.5528, -116.573, NULL, NULL),
('820200895', 'ID0105061', 'ID0105061', 'IDBOISTD', 'Caldwell Cancer Care Center Medical Oncology', '', '', 'Caldwell  Cancer Care Center - Medical Oncology', 'Group', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083673627', NULL, '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083673627', '', 'IDHOSPOP', '', '', '0.00', '20.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '0000005528', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6594, -116.659, NULL, NULL),
('841636078', 'ID0105043', 'ID0105043', 'IDBOISTD', 'River Medical Family Practice', 'Michael', 'R', 'Minas', 'MD', 'Family Practice', '', '', NULL, 'B', '3210 E Chinden Blvd Ste 115', 'Eagle', 'Ada', 'ID', '83616', '2089393314', '          ', '3210 E Chinden Blvd Ste 115', 'Eagle', 'Ada', 'ID', '83616', '2089393314', '          ', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', '2014-04-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528178977', 0, 'Y', 0, '2014-07-08', NULL, NULL, 0, 0, NULL, NULL),
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('820200895', 'ID0105048', 'ID0105048', 'IDBOISTD', 'Saint Alphonsus Cancer Care Center', '', '', 'Saint Alphonsus Cancer Care Center', 'Group', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673454', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673454', '', 'IDHOSPOP', '', '', '0.00', '20.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '0000008539', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6145, -116.254, NULL, NULL),
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('519376897', 'ID0105081', 'ID0105081', 'IDBOISTD', 'Boise Neurological Consultants', 'James', 'D', 'Redshaw', 'MD', 'Neurology', '', '', NULL, 'O', '999 N Curtis Rd Ste 506', 'Boise', 'Ada', 'ID', '83706', '2083672800', NULL, '999 N Curtis Rd Ste 506', 'Boise', 'Ada', 'ID', '83706', '2083672800', '', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1487640561', 0, 'n', 0, '2014-05-19', NULL, NULL, 43.6134, -116.254, NULL, NULL),
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('097345729', 'ID0105083', 'ID0105083', 'IDBOISTD', 'Boise Neurological Consultants', 'Richard', 'W', 'Wilson', 'MD', 'Neurology', '', '', NULL, 'O', '999 N Curtis Rd Ste 506', 'Boise', 'Ada', 'ID', '83706', '2083672800', NULL, '999 N Curtis Rd Ste 506', 'Boise', 'Ada', 'ID', '83706', '2083672800', '', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1982691598', 0, 'n', 0, '2012-08-20', NULL, NULL, 43.6134, -116.254, NULL, NULL),
('742083988', 'TX0105124', 'TX0105124', 'TXSATSTD', 'Renal Associates', 'Fadi', '', 'Abouzahr', 'MD', 'Nephrology', '', '', NULL, 'O', '4499 Medical Dr Ste 102', 'San Antonio', 'Bexar', 'TX', '78229', '2109490469', NULL, '4499 Medical Dr Ste 102', 'San Antonio', 'Bexar', 'TX', '78229', '2109490469', '          ', 'TXSTD', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', '2013-05-05', 0, 0, 0, 'Baptist Medical Center', '', '', '', 'HCFA|UB|', '1982695896', 0, 'N', 0, '2013-05-24', NULL, NULL, 29.5105, -98.5737, NULL, NULL),
('820477852', 'ID0105160', 'ID0105160', 'IDBOISTD', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'Stacey', '', 'Townsend', 'MD', 'Pediatrics', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', NULL, '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '', 'IDSAMG2', NULL, '', '0.00', '10.00', '0.00', 6, '2012-08-20', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1962554568', 0, 'n', 0, '2014-06-20', NULL, NULL, 43.6896, -116.35, NULL, NULL),
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