{
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"NPI": "1356746119",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MARISA H. FOX, DDS, INC",
"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": "715 VEGAS RIO",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HELOTES",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78023-4639",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "210-520-3841",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7900 SHIN OAK DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LIVE OAK",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78233-2411",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "210-654-1851",
"PracticeLocationAddressFaxNumber": "210-654-3078",
"EnumerationDate": "10/22/2014",
"LastUpdateDate": "10/22/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FOX",
"AuthorizedOfficialFirstName": "MARISA",
"AuthorizedOfficialMiddleName": "HWA",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "210-520-3841",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "16509",
"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."
}
}
}
}