Nancy A Logan, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

23696 Issued in TX

Practice address

24123 Boerne Stage Rd
Suite 430
San Antonio, TX 78235-9404

Phone

(210) 615-0555

Fax

(210) 687-1100

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2017 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1114947579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24123 BOERNE STAGE RD",
            "address_2": "SUITE 430",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782359404",
            "telephone_number": "210-615-0555",
            "fax_number": "210-687-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24123 BOERNE STAGE RD",
            "address_2": "SUITE 430",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782359404",
            "telephone_number": "210-615-0555",
            "fax_number": "210-687-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "NANCY",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "23696",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "614",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00G66C",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Logan, FNP-C
• Erika Lynn Logan, PN338207
• James Logan, CTRS
• Jastalie Logan
• Mikyla Brittany Logan
• Richard B. Logan
• Tanya Logan, LVN
• Priyadarshini Loganathan, MD
• Kelley Patricia Logans-Ali, LCSW-S
• Mitchell Logeais

• Psychologist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.