Organization Active NPI

Richard O Temple PHD PLLC

Doing business as Mind For Sports

  • Clinical Neuropsychologist
  • Austin, TX
National Provider Identifier
1235551086
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
32760 Issued in TX
Legal business name
RICHARD O TEMPLE PHD PLLC
Doing business as
Mind For Sports
Practice address
706B W Ben White Blvd
Ste 120B
Austin, TX 78704-7153
Phone
(512) 318-1833
Fax
(512) 852-4771
NPI assigned
Jan 14, 2014
Last updated
Jan 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Authorized official

Name
Dr. Richard O Temple, PHDNPI 1366609265
Title
Owner
Phone
(512) 294-2304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 32760 TX Primary

Addresses

Primary practice location

706B W Ben White Blvd
Ste 120B
Austin, TX 78704-7153

Mailing address

PO Box 145
Dripping Springs, TX 78620-0145
Phone (512) 318-1833

Other identifiers 1

IdentifierTypeStateIssuer
1366609265OtherTXRICHARD O TEMPLE'S PERSONAL NPI

Other names 1

  • Mind For Sports Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140122001415 TX Part B Supplier - Clinic/Group Practice 2769610609 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

706 W Ben White Blvd
Ste B120
Austin, TX 78704
Phone (512) 294-2304

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1389657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389657600000",
    "number": "1235551086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 145",
            "city": "DRIPPING SPRINGS",
            "state": "TX",
            "postal_code": "786200145",
            "telephone_number": "512-318-1833",
            "fax_number": "512-852-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706B W BEN WHITE BLVD",
            "address_2": "STE 120B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047153",
            "telephone_number": "512-318-1833",
            "fax_number": "512-852-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD O TEMPLE PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-14",
        "last_updated": "2014-01-14",
        "status": "A",
        "authorized_official_last_name": "TEMPLE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-294-2304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "32760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RICHARD O TEMPLE'S PERSONAL NPI",
            "identifier": "1366609265",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mind For Sports",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.