{
"Npi": {
"NPI": "1023327632",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GINNY FULLERTON, PH.D PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1401 CASTLE CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77006-5703",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "713-568-6837",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1401 CASTLE CT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOUSTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77006-5703",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "713-568-6837",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/29/2010",
"LastUpdateDate": "11/05/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FULLERTON",
"AuthorizedOfficialFirstName": "LAURA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PSYCHOLOGIST, PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PH.D",
"AuthorizedOfficialTelephoneNumber": "713-568-6837",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "33888",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}