Tiara A Roberts, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

222537 Issued in TX

Practice address

317 N Broadway Rd
Azle, TX 76020-3776

Phone

(817) 444-3603

Fax

(817) 406-4140

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• James Boysen, M.D., PA

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  • NPI 1902163793
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1326088535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 N BROADWAY RD",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203776",
            "telephone_number": "817-444-3603",
            "fax_number": "817-406-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N BROADWAY RD",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203776",
            "telephone_number": "817-444-3603",
            "fax_number": "817-406-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TIARA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "222537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "00DO5R",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032590401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas L Reid Jr., LPT
• Ashley Renegar
• David Wesley Rindfusz, MD
• Edwin Earl Robbins, PHARMD
• Kelsey Robers
• Kelvin Duane Robison, MD
• Isaac Rodriguez
• Sylvia Rodriguez
• Sasha Nicole Rousey, M.S.
• Frank Rubal

• Psychologist in Azle, TX
• Providers in Azle, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.