Active NPI
Iman J Ross, PH.D
- Professional Counselor
- Duncanville, TX
National Provider Identifier
1346378361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 18030
- Practice address
- 1106 Santa Fe TRL Ste 2
Duncanville, TX 75137-3063 - Phone
- (469) 236-3999
- Fax
- (469) 293-4144
- NPI assigned
- Mar 1, 2007
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 18030 | TX | Primary |
Addresses
Primary practice location
1106 Santa Fe TRL Ste 2
Duncanville, TX 75137-3063
Mailing address
1106 Santa Fe TRL Ste 2
Duncanville, TX 75137-3063
Phone (469) 236-3999
Other practice location 1
3840 Hulen St
Fort Worth, TX 76107-7277
Phone (817) 335-3022
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 |
|---|---|---|---|
| 18030 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554681600000",
"number": "1346378361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1106 SANTA FE TRL STE 2",
"city": "DUNCANVILLE",
"state": "TX",
"postal_code": "751373063",
"telephone_number": "469-236-3999",
"fax_number": "469-293-4144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1106 SANTA FE TRL STE 2",
"city": "DUNCANVILLE",
"state": "TX",
"postal_code": "751373063",
"telephone_number": "469-236-3999",
"fax_number": "469-293-4144"
}
],
"practiceLocations": [
{
"address_1": "3840 Hulen St",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761077277",
"country_code": "US",
"telephone_number": "817-335-3022",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSS",
"first_name": "IMAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2019-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "18030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Duncanville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.