Active NPI
Paul K Chafetz, PHD
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1033129747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 22365
- Practice address
- 8340 Meadow Rd Ste 134
#134
Dallas, TX 75231 - Phone
- (469) 233-5566
- NPI assigned
- Aug 8, 2006
- Last updated
- May 24, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 22365 | TX | Primary |
Addresses
Primary practice location
8340 Meadow Rd Ste 134
#134
Dallas, TX 75231
Mailing address
PO Box 92878
Southlake, TX 76092
Phone (817) 470-6676
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620001485 | Other | TX | MEDICARE RAILROAD |
| 00SD78 | Other | TX | BLUE CROSS BLUE SHIELD |
| 035835001 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22365 | TX | MD | Pharmacist |
| 22365 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suzanne M. Guynes, M.D.P.a. | Past | Accepting new patients | |
| Paul K. Chafetz, PH.D | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychologist
- Dallas, TX
- NPI 1689801664
-
- Geriatric Psychiatry Physician
- Weatherford, TX
- NPI 1063601466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527120000000",
"number": "1033129747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 92878",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "76092",
"telephone_number": "817-470-6676",
"fax_number": "541-637-0298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8340 MEADOW RD STE 134",
"address_2": "#134",
"city": "DALLAS",
"state": "TX",
"postal_code": "75231",
"telephone_number": "469-233-5566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAFETZ",
"first_name": "PAUL",
"middle_name": "K",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2018-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "22365",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "620001485",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00SD78",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "035835001",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.