Active NPI
Samuel B Tobler, PH.D.
- Clinical Psychologist
- Dyess Afb, TX
National Provider Identifier
1053502401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 40026
- Practice address
- 697 Louisiana Rd BLDG 9201
Dyess Afb, TX 79607-1141 - Phone
- (325) 696-5380
- NPI assigned
- Aug 9, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7520147-2501 | UT | |
| Clinical Psychologist | 103TC0700X | 40026 | TX | Primary |
Addresses
Primary practice location
697 Louisiana Rd BLDG 9201
Dyess Afb, TX 79607-1141
Mailing address
697 Louisiana Rd BLDG 9201
Dyess Afb, TX 79607-1141
Phone (325) 696-5380
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40026 | TX | MD | Clinical Psychologist |
| 7520147-2501 | UT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1053502401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "697 LOUISIANA RD BLDG 9201",
"city": "DYESS AFB",
"state": "TX",
"postal_code": "796071141",
"telephone_number": "325-696-5380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "697 LOUISIANA RD BLDG 9201",
"city": "DYESS AFB",
"state": "TX",
"postal_code": "796071141",
"telephone_number": "325-696-5380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOBLER",
"first_name": "SAMUEL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-09",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "7520147-2501",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "40026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dyess Afb, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.