Individual provider Active NPI

Angela Michele Heads, PH.D,

  • Psychologist
  • Houston, TX
National Provider Identifier
1114226453
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
34989 Issued in TX
Practice address
2825 Wilcrest Dr
Suite 162
Houston, TX 77042-3391
Phone
(281) 536-7479
Fax
(281) 586-0664
NPI assigned
Mar 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 34989 TX Primary
Counseling Psychologist 103TC1900X 34989
Health Psychologist 103TH0004X 34989 TX
Group Psychotherapy Psychologist 103TP2701X 34989 TX

Addresses

Primary practice location

2825 Wilcrest Dr
Suite 162
Houston, TX 77042-3391

Mailing address

4726 Silver Frost Dr
Houston, TX 77066-4730
Phone (281) 536-7479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120515000152 TX Practitioner - Clinical Psychologist 5698938405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

1941 E Rd
Houston, TX 77054-6010

6410 Fannin St
Houston, TX 77030-3005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
34989TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Oct 1, 2015 Accepting new patients
Ut Physicians CurrentSince Oct 1, 2015 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

1941 East Rd
Houston, TX 77054
Phone (713) 486-2500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1114226453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4726 SILVER FROST DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770664730",
            "telephone_number": "281-536-7479",
            "fax_number": "281-586-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 WILCREST DR",
            "address_2": "SUITE 162",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770423391",
            "telephone_number": "281-536-7479",
            "fax_number": "281-586-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADS",
        "first_name": "ANGELA",
        "middle_name": "MICHELE",
        "credential": "PH.D,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "34989",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": "34989",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "TX",
            "license": "34989",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "TX",
            "license": "34989",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.