Individual provider Active NPI

Saul Rodriguez

  • Counseling Psychologist
  • Fort Worth, TX
National Provider Identifier
1013780048
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
91908 Issued in TX
Practice address
4545 Bellaire Dr S Ste 6
Fort Worth, TX 76109-1811
Phone
(817) 657-1115
NPI assigned
Nov 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 91908 TX Primary

Addresses

Primary practice location

4545 Bellaire Dr S Ste 6
Fort Worth, TX 76109-1811

Mailing address

4545 Bellaire Dr S Ste 6
Fort Worth, TX 76109-1811
Phone (817) 657-1115

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
91908TXMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling by Penny PastSince Nov 5, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1013780048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 BELLAIRE DR S STE 6",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091811",
            "telephone_number": "817-657-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 BELLAIRE DR S STE 6",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091811",
            "telephone_number": "817-657-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "SAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "91908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.