{
"Npi": {
"NPI": "1720471808",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "THOMASON",
"FirstName": "MOLLY",
"MiddleName": "MISHLER",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PH.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MISHLER",
"OtherFirstName": "MOLLY",
"OtherMiddleName": "THERESA",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "15902 CREEK HILL LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CYPRESS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77429-3475",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-208-1183",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "707 S FRY RD STE 160",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KATY",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77450-2257",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "281-371-6082",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/12/2015",
"LastUpdateDate": "10/03/2025",
"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": "103G00000X",
"TaxonomyName": "Clinical Neuropsychologist",
"LicenseNumber": "37600",
"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."
}
}
}
}