Active NPI
Jill K McGavin, PHD
- Psychologist
- Houston, TX
National Provider Identifier
1366464893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 23703
- Practice address
- 2002 Holcombe Blvd
Medvamc 116SDVR
Houston, TX 77030-4211 - Phone
- (713) 794-0705
- NPI assigned
- Jul 24, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 23703 | TX | Primary |
Addresses
Primary practice location
2002 Holcombe Blvd
Medvamc 116SDVR
Houston, TX 77030-4211
Mailing address
2002 Holcombe Blvd
Medvamc 116SDVR
Houston, TX 77030-4211
Phone (713) 794-0705
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 |
|---|---|---|---|
| 23703 | TX | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366464893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 HOLCOMBE BLVD",
"address_2": "MEDVAMC 116SDVR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304211",
"telephone_number": "713-794-0705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 HOLCOMBE BLVD",
"address_2": "MEDVAMC 116SDVR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304211",
"telephone_number": "713-794-0705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGAVIN",
"first_name": "JILL",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "23703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.