Active NPI
Mark Powers, PH.D.
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1194091793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 34892
- Practice address
- 3500 Gaston Ave
Dallas, TX 75246-2017 - Phone
- (214) 865-2409
- NPI assigned
- Mar 28, 2012
- Last updated
- May 10, 2018
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 34892 | TX | Primary |
Addresses
Primary practice location
3500 Gaston Ave
Dallas, TX 75246-2017
Mailing address
3409 Worth St Ste C2.500
Dallas, TX 75246-2029
Phone (214) 865-2409
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 |
|---|---|---|---|
| 34892 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525910400000",
"number": "1194091793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3409 WORTH ST STE C2.500",
"city": "DALLAS",
"state": "TX",
"postal_code": "752462029",
"telephone_number": "214-865-2409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 GASTON AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752462017",
"telephone_number": "214-865-2409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWERS",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-28",
"last_updated": "2018-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "34892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.