{
"Npi": {
"NPI": "1770959165",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "REESE CHIROPRACTIC SPINE BY DESIGN",
"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": "4603 FM 1463 RD STE 400",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KATY",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77494-6545",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "832-913-8970",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4603 FM 1463 RD STE 400",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KATY",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77494-6545",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "832-913-8970",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/19/2015",
"LastUpdateDate": "08/19/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HULS",
"AuthorizedOfficialFirstName": "SANDRA",
"AuthorizedOfficialMiddleName": "WENTZEL",
"AuthorizedOfficialTitle": "CHIROPRACTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC, RN, RD",
"AuthorizedOfficialTelephoneNumber": "740-296-9347",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "12408",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}