Senior Neuropsychological Associates, PC

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

31579 Issued in TX

Legal business name

SENIOR NEUROPSYCHOLOGICAL ASSOCIATES, PC

Practice address

6225 Paper Shell Way
Fort Worth, TX 76179-9286

Phone

(817) 988-1236

Fax

(817) 750-1237

NPI assigned

Nov 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bret G Bentz, PHDNPI 1174552426

Title

Owner

Phone

(817) 988-1236

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bret Bentz, PHD

  • Cognitive & Behavioral Psychologist
  • Fort Worth, TX
  • NPI 1174552426
  Medicare reassignment NPD Authorized official
• Asad Ul Islam, MD

  • Psychiatry Physician
  • Lewisville, TX
  • NPI 1841248846
  NPD (past)

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1356522288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 PAPER SHELL WAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761799286",
            "telephone_number": "817-988-1236",
            "fax_number": "817-750-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 PAPER SHELL WAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761799286",
            "telephone_number": "817-988-1236",
            "fax_number": "817-750-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR NEUROPSYCHOLOGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "BENTZ",
        "authorized_official_first_name": "BRET",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-988-1236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TX",
            "license": "31579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159445901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0015MJ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohan Sengodan, MD
• Senior Care Consultants at Home, LTD
• Senior Health Pharmacy
• Senior Health Richland LLC
• Senior Management Services of Estates at Fort Worth Inc
• Senior Rehab Innovators PLLC
• Chrystyna Kaulbach Senkel, PA
• Anirban Sensarma, M.D.
• Senso Weight Loss, LLC
• Sensotherapy Medical Associates PA

• Cognitive & Behavioral Psychologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Cognitive & Behavioral Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.