{
"Npi": {
"NPI": "1881124790",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DELORES E. WHITE PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4702 N LAURENT ST STE D",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VICTORIA",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77904-2158",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "361-572-0202",
"MailingAddressFaxNumber": "361-572-0300",
"FirstLinePracticeLocationAddress": "4702 N LAURENT ST STE D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VICTORIA",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77904-2158",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "361-572-0202",
"PracticeLocationAddressFaxNumber": "361-572-0300",
"EnumerationDate": "06/13/2017",
"LastUpdateDate": "09/23/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHITE",
"AuthorizedOfficialFirstName": "DELORES",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "SOLE OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "361-572-0202",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "66862",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}