1326822107 NPI number — BARBARA GAIL WHITE LMT, MTI, BCTMB, CLT

NPI Number: 1326822107
Health Care Provider/Practitioner: BARBARA GAIL WHITE LMT, MTI, BCTMB, CLT

NPI Number : 1326822107 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326822107",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WHITE",
    "FirstName": "BARBARA",
    "MiddleName": "GAIL",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LMT, MTI, BCTMB, CLT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MARTIN",
    "OtherFirstName": "BARBARA",
    "OtherMiddleName": "GAIL",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LMT, MTI, BCTMB, CL",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3560 DELAWARE ST STE 501",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BEAUMONT",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77706-3061",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "409-626-1811",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3560 DELAWARE ST STE 501",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BEAUMONT",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77706-3061",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "409-626-1811",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/22/2023",
    "LastUpdateDate": "08/24/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": "419601-00",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": "MT023126",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}