Active NPI
Ann I Roose, PHD
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1063637221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23644
- Practice address
- 7424 Greenville Ave
Ste 104
Dallas, TX 75231-4552 - Phone
- (214) 536-2745
- Fax
- (877) 282-8166
- NPI assigned
- Apr 14, 2007
- Sex
- Female
- 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 | 23644 | TX | Primary |
Addresses
Primary practice location
7424 Greenville Ave
Ste 104
Dallas, TX 75231-4552
Mailing address
2309 Chinaberry Dr
Bedford, TX 76021-5209
Phone (214) 536-2745
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 |
|---|---|---|---|
| 23644 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1063637221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2309 CHINABERRY DR",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760215209",
"telephone_number": "214-536-2745",
"fax_number": "877-282-8166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7424 GREENVILLE AVE",
"address_2": "STE 104",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314552",
"telephone_number": "214-536-2745",
"fax_number": "877-282-8166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOSE",
"first_name": "ANN",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "23644",
"primary": true
}
],
"identifiers": [],
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.