Active NPI
Jan Ford Mustin, PH.D.
- Clinical Psychologist
- West Lake Hills, TX
National Provider Identifier
1275714206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 21717
- Practice address
- 4407 Bee Cave Rd
Suite 411
West Lake Hills, TX 78746-6405 - Phone
- (512) 347-8100
- Fax
- (512) 347-8200
- NPI assigned
- Nov 19, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 21717 | TX | Primary |
Addresses
Primary practice location
4407 Bee Cave Rd
Suite 411
West Lake Hills, TX 78746-6405
Mailing address
4407 Bee Cave Rd
Suite 411
West Lake Hills, TX 78746-6405
Phone (512) 347-8100
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 |
|---|---|---|---|
| 21717 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195430400000",
"number": "1275714206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4407 BEE CAVE RD",
"address_2": "SUITE 411",
"city": "WEST LAKE HILLS",
"state": "TX",
"postal_code": "787466405",
"telephone_number": "512-347-8100",
"fax_number": "512-347-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4407 BEE CAVE RD",
"address_2": "SUITE 411",
"city": "WEST LAKE HILLS",
"state": "TX",
"postal_code": "787466405",
"telephone_number": "512-347-8100",
"fax_number": "512-347-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSTIN",
"first_name": "JAN",
"middle_name": "FORD",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-19",
"last_updated": "2007-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "21717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lake Hills, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.