Injury One of Wichita Falls, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

32981 Issued in TX

Legal business name

INJURY ONE OF WICHITA FALLS, LLC

Practice address

2611 Plaza Pkwy
Suite 302
Wichita Falls, TX 76308-3886

Phone

(214) 563-5122

Fax

(214) 361-1235

NPI assigned

Mar 23, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Nat E Mangum

Title

Ceo

Phone

(214) 692-6666

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1154562031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5931 DESCO DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752251604",
            "telephone_number": "214-563-5122",
            "fax_number": "214-361-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 PLAZA PKWY",
            "address_2": "SUITE 302",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763083886",
            "telephone_number": "214-563-5122",
            "fax_number": "214-361-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INJURY ONE OF WICHITA FALLS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "NAT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-692-6666",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "15520",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "32981",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "33427",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.