Organization Active NPI

Nancy a Logan, PHD. PC

  • Psychologist
  • San Antonio, TX
National Provider Identifier
1407004971
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
23696 Issued in TX
Legal business name
NANCY A LOGAN, PHD. PC
Practice address
24123 Boerne Stage Rd
Suite 430
San Antonio, TX 78255-9403
Phone
(210) 615-0555
Fax
(210) 687-1100
NPI assigned
Sep 8, 2008
Last updated
Oct 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Authorized official

Name
Mrs. Mary Ann Hildebrand
Title
Office Manager
Phone
(210) 615-0555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 23696 TX Primary

Addresses

Primary practice location

24123 Boerne Stage Rd
Suite 430
San Antonio, TX 78255-9403

Mailing address

24123 Boerne Stage Rd
Suite 430
San Antonio, TX 78255-9403
Phone (210) 615-0555

Other identifiers 1

IdentifierTypeStateIssuer
00G66COtherTXBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

24123 Boerne Stage Rd
Ste 430
San Antonio, TX 78255
Phone (210) 615-0555

7950 Floyd Curl Dr
Ste 503
San Antonio, TX 78229
Phone (210) 615-0555

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1407004971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24123 BOERNE STAGE RD",
            "address_2": "SUITE 430",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782559403",
            "telephone_number": "210-615-0555",
            "fax_number": "210-687-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24123 BOERNE STAGE RD",
            "address_2": "SUITE 430",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782559403",
            "telephone_number": "210-615-0555",
            "fax_number": "210-687-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY A LOGAN, PHD. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "HILDEBRAND",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-615-0555",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "23696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00G66C",
            "state": "TX"
        }
    ],
    "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 Oct 2, 2008; 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.