Active NPI
Avni Vyas, PH.D
- Clinical Psychologist
- Southlake, TX
National Provider Identifier
1174643282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 31570
- Practice address
- 10725 East Southlake Blvd
102
Southlake, TX 76092-6457 - Phone
- (817) 618-9307
- Fax
- (817) 977-8553
- NPI assigned
- Mar 30, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 31570 | TX | |
| Clinical Psychologist | 103TC0700X | 31570 | TX | Primary |
Addresses
Primary practice location
10725 East Southlake Blvd
102
Southlake, TX 76092-6457
Mailing address
4705 Lafite LN
Colleyville, TX 76034-1384
Phone (817) 618-9307
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31570 | TX | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1174643282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4705 LAFITE LN",
"city": "COLLEYVILLE",
"state": "TX",
"postal_code": "760341384",
"telephone_number": "817-618-9307",
"fax_number": "817-977-8553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10725 EAST SOUTHLAKE BLVD",
"address_2": "102",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926457",
"telephone_number": "817-618-9307",
"fax_number": "817-977-8553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VYAS",
"first_name": "AVNI",
"name_prefix": "Ms.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "31570",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "31570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.