Organization Active NPI

At4K Texas Providers PLLC

  • Intellectual & Developmental Disabilities Psychologist
  • Grapevine, TX
National Provider Identifier
1003626581
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
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

Updated by the provider on Feb 7, 2025

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)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TM1800X Primary
Developmental - Behavioral Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Locations

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.

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.

Verify at the official NPI Registry.