Albert E Mayo, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

31003 Issued in TX

Practice address

912 S. Ervay
Dallas, TX 75201

Phone

(214) 478-8379

Fax

(972) 581-4313

NPI assigned

Oct 5, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1366794059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 PRATT RD",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751545228",
            "telephone_number": "214-478-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S. ERVAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75201",
            "telephone_number": "214-478-8379",
            "fax_number": "972-581-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "ALBERT",
        "middle_name": "E",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-05",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "31003",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31003",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307679608",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CSHCN",
            "identifier": "307679609",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NUMBER",
            "identifier": "89440A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mayflower Medical Center
• Jillian Jo Mayhood, CRNA
• Mark Edward Mayhugh, M.S.
• Malea Pruszenski Maynard, M.D.
• Mark Justin Maynard, DO
• Andre Mayo
• Brittany Mayo, LCPC
• Erin Doyle Mayo, PNP-AC
• Marlyn Jean Mayo, MD
• Rebecca Ariel Mayo, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.