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        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 2</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is distributed to all members of the governing body for review before the tax return is filed</ExplanationTxt>
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        <ExplanationTxt>Based on the summary of conflict issues, the board removes the person with a conflict from voting on such issues.</ExplanationTxt>
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        <ExplanationTxt>All documents are available upon request.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Based on the summary of conflict issues, the board removes the person with a conflict from voting on such issues.</ExplanationTxt>
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      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Obria Medical Clinic Houston Bay rea LLC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>181673</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Costs</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
