Active NPI
John Manuel Pita, PH.D.
- Clinical Psychologist
- Plano, TX
National Provider Identifier
1043314560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 24790
- Practice address
- 900 Hedgcoxe Rd
Plano, TX 75025-2554 - Phone
- (972) 765-2643
- Fax
- (214) 698-4497
- NPI assigned
- Sep 13, 2006
- 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 | 24790 | TX | Primary |
Addresses
Primary practice location
900 Hedgcoxe Rd
Plano, TX 75025-2554
Mailing address
PO Box 226464
Dallas, TX 75222-6464
Phone (972) 765-2643
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 |
|---|---|---|---|
| 24790 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248048000000",
"number": "1043314560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 226464",
"city": "DALLAS",
"state": "TX",
"postal_code": "752226464",
"telephone_number": "972-765-2643",
"fax_number": "214-698-4497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 HEDGCOXE RD",
"city": "PLANO",
"state": "TX",
"postal_code": "750252554",
"telephone_number": "972-765-2643",
"fax_number": "214-698-4497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITA",
"first_name": "JOHN",
"middle_name": "MANUEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2009-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "24790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.