Active NPI
At4K Texas Providers PLLC
- Intellectual & Developmental Disabilities Psychologist
- Grapevine, TX
National Provider Identifier
1003626581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- Legal business name
- AT4K TEXAS PROVIDERS PLLC
- Practice address
- 1100 S Main St Ste 103
Grapevine, TX 76051-7531 - Phone
- (817) 310-5510
- NPI assigned
- Jan 8, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chris Tillotson
- Title
- Ceo
- Phone
- (248) 770-9929
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | Primary | ||
| Developmental - Behavioral Pediatrics Physician | 2080P0006X |
Addresses
Primary practice location
1100 S Main St Ste 103
Grapevine, TX 76051-7531
Mailing address
112 Walnut Blvd Unit 308
Rochester, MI 48307-2317
Other practice location 1
11240 Farm to Market 1960 Rd W
Ste 201
Houston, TX 77065
Phone (817) 310-5510
National Provider Directory
National Provider DirectoryLocations
1100 S Main St
Ste 103
Grapevine, TX 76051
Phone (817) 310-5510
11240 FM 1960 Rd W
Ste 201
Houston, TX 77065
Phone (817) 310-5510
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatric Neurodevelopmental Disabilities Physician
- Grapevine, TX
- NPI 1467650564
Developmental - Behavioral Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738886400000",
"number": "1003626581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 WALNUT BLVD UNIT 308",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "483072317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 S MAIN ST STE 103",
"city": "GRAPEVINE",
"state": "TX",
"postal_code": "760517531",
"telephone_number": "817-310-5510"
}
],
"practiceLocations": [
{
"address_1": "11240 Farm to Market 1960 Rd W",
"address_2": "Ste 201",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "77065",
"country_code": "US",
"telephone_number": "817-310-5510",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "AT4K TEXAS PROVIDERS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-08",
"last_updated": "2025-02-07",
"certification_date": "2025-02-05",
"status": "A",
"authorized_official_last_name": "TILLOTSON",
"authorized_official_first_name": "CHRIS",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "248-770-9929"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": true
},
{
"code": "2080P0006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grapevine, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.