Active NPI
David Richard Missimo, MD
- Psychiatry Physician
- Plano, TX
National Provider Identifier
1184842064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- JO133
- Practice address
- 5824 W Plano Pkwy
104
Plano, TX 75093-4636 - Phone
- (972) 818-9355
- Fax
- (972) 818-9356
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | JO133 | TX | Primary |
Addresses
Primary practice location
5824 W Plano Pkwy
104
Plano, TX 75093-4636
Mailing address
4608 Stonehollow Way
Dallas, TX 75287-7522
Phone (972) 381-8618
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 Medicine, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JO133 | TX | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184842064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4608 STONEHOLLOW WAY",
"city": "DALLAS",
"state": "TX",
"postal_code": "752877522",
"telephone_number": "972-381-8618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5824 W PLANO PKWY",
"address_2": "104",
"city": "PLANO",
"state": "TX",
"postal_code": "750934636",
"telephone_number": "972-818-9355",
"fax_number": "972-818-9356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISSIMO",
"first_name": "DAVID",
"middle_name": "RICHARD",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "JO133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.