Organization Active NPI

Vericare of Texas, P.a.

  • Psychiatry Physician
  • Kingwood, TX
National Provider Identifier
1033160825
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
VERICARE OF TEXAS, P.A.
Practice address
24025 Kingwood Place Dr
Kingwood, TX 77339-3862
Phone
(800) 257-8715
Fax
(800) 819-1655
NPI assigned
May 15, 2006
Last updated
Jan 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Authorized official

Name
Darla Dunn
Title
Director
Phone
(860) 510-0888

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X TX
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X TX
Psychiatry Physician 2084P0800X TX Primary

Addresses

Primary practice location

24025 Kingwood Place Dr
Kingwood, TX 77339-3862

Mailing address

1480 Boston Post Rd
Old Saybrook, CT 06475-1750
Phone (800) 370-3651

Other identifiers 2

IdentifierTypeStateIssuer
130082404MedicaidTX
CG8005OtherTXRAILROAD MEDICARE

Other names 1

  • Vericare Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1033160825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 BOSTON POST RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751750",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24025 KINGWOOD PLACE DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773393862",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERICARE OF TEXAS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "860-510-0888"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130082404",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG8005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vericare",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Vericare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.