Individual provider Active NPI

Robert Warren Heffer Jr., PH.D.

  • Clinical Psychologist
  • College Station, TX
National Provider Identifier
1003910449
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24746 Issued in TX
Practice address
408 Tarrow St East
College Station, TX 77840-7811
Phone
(979) 268-1111
Fax
(979) 268-5803
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 24746 TX Primary

Addresses

Primary practice location

408 Tarrow St East
College Station, TX 77840-7811

Mailing address

408 Tarrow St East
College Station, TX 77840-7811
Phone (979) 268-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
24746TXMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1003910449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 TARROW ST EAST",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778407811",
            "telephone_number": "979-268-1111",
            "fax_number": "979-268-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 TARROW ST EAST",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778407811",
            "telephone_number": "979-268-1111",
            "fax_number": "979-268-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFER",
        "first_name": "ROBERT",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "24746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.