Individual provider Active NPI

Sandra Harper, PH.D.

  • Psychologist
  • Tyler, TX
National Provider Identifier
1033127279
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
24006 Issued in TX
Practice address
2010 Sybil LN Ste 100
Tyler, TX 75703
Phone
(903) 596-8118
Fax
(903) 596-8125
NPI assigned
Aug 3, 2006
Last updated
Apr 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 24006 TX Primary

Addresses

Primary practice location

2010 Sybil LN Ste 100
Tyler, TX 75703

Mailing address

2010 Sybil LN Ste 100
Tyler, TX 75703-1817
Phone (903) 596-8118

Other identifiers 1

IdentifierTypeStateIssuer
030454505MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140116000215 TX Practitioner - Clinical Psychologist 3577736263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1820 Shiloh Rd
Suite 1503
Tyler, TX 75703-2459
Phone (903) 596-8118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24006TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sandy Harper PC Psychologist Current Accepting new patients
Sandra Harper PLLC Psychologist CurrentSince Oct 8, 2018 Accepting new patients

Locations

1820 Shiloh Rd
Ste 1503
Tyler, TX 75703
Phone (903) 596-8118

2010 Sybil Ln
Ste 100
Tyler, TX 75703
Phone (903) 596-8118

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1033127279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 SYBIL LN STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031817",
            "telephone_number": "903-596-8118",
            "fax_number": "903-596-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 SYBIL LN STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-596-8118",
            "fax_number": "903-596-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "SANDRA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "24006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030454505",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.