Individual provider Active NPI

Marie Dahdah, PH.D.

  • Clinical Neuropsychologist
  • Frisco, TX
National Provider Identifier
1144669599
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
34510 Issued in TX
Practice address
9741 Preston Rd Ste 203
Frisco, TX 75033-2554
Phone
(415) 730-1177
NPI assigned
Jun 19, 2013
Last updated
Jun 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 34510 TX Primary
Psychologist 103T00000X 34510 TX
Cognitive & Behavioral Psychologist 103TB0200X 34510 TX
Clinical Psychologist 103TC0700X 34510 TX
Rehabilitation Psychologist 103TR0400X 34510 TX
Health Psychologist 103TH0004X 34510 TX

Addresses

Primary practice location

9741 Preston Rd Ste 203
Frisco, TX 75033-2554

Mailing address

9741 Preston Rd Ste 203
Frisco, TX 75033-2554
Phone (415) 730-1177

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
I20200812000980 TX Practitioner - Clinical Psychologist 8820414501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2591 Dallas Pkwy
Suite 300
Frisco, TX 75034-8563
Phone (415) 730-1177

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Star Neuropsychology, PLLC CurrentSince Jun 18, 2020 Accepting new patients

Locations

2591 Dallas Pkwy
Ste 300
Frisco, TX 75034
Phone (469) 708-9380

8992 Preston Rd
Ste 110760
Frisco, TX 75034

9741 Preston Rd
Ste 203
Frisco, TX 75033
Phone (415) 730-1177

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1144669599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9741 PRESTON RD STE 203",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750332554",
            "telephone_number": "415-730-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9741 PRESTON RD STE 203",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750332554",
            "telephone_number": "415-730-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHDAH",
        "first_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "34510",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "34510",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TX",
            "license": "34510",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34510",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "TX",
            "license": "34510",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "TX",
            "license": "34510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.