Active NPI
Eric David Powell, PH.D.
- Clinical Psychologist
- San Antonio, TX
National Provider Identifier
1326662685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 37727
- Practice address
- 4230 Gardendale St Ste 502
San Antonio, TX 78229-3699 - Phone
- (314) 540-6067
- NPI assigned
- Jun 2, 2020
- Last updated
- Jun 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 37727 | TX | Primary |
| Health Service Psychologist | 103TH0100X | |||
| Health Psychologist | 103TH0004X |
Addresses
Primary practice location
4230 Gardendale St Ste 502
San Antonio, TX 78229-3699
Mailing address
4230 Gardendale St Ste 502
San Antonio, TX 78229-3699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 10, 2021 through Dec 10, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37727 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restoring Balance, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Marriage & Family Therapist
- San Antonio, TX
- NPI 1396331591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591056000000",
"number": "1326662685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4230 GARDENDALE ST STE 502",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4230 GARDENDALE ST STE 502",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293699",
"telephone_number": "314-540-6067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "ERIC",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-02",
"last_updated": "2020-06-02",
"certification_date": "2020-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "37727",
"primary": true
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.