K.P. Ezichi

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

K.P. EZICHI

Practice address

14665 Preston Rd
Dallas, TX 75254-7880

Phone

(817) 290-4225

NPI assigned

Feb 2, 2023

Organization subpart

No

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

Authorized official

Name

K.P. Ezichi, PSY,MD

Title

Staff

Phone

(817) 290-4225

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1427754241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14665 PRESTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547880",
            "telephone_number": "817-290-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14665 PRESTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547880",
            "telephone_number": "817-290-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K.P. EZICHI",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "EZICHI",
        "authorized_official_first_name": "K.P.",
        "authorized_official_title_or_position": "STAFF",
        "authorized_official_telephone_number": "817-290-4225",
        "authorized_official_credential": "PSY,MD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.