Organization Active NPI

Bernard J. Gotway, PH.D., P.C.

  • Clinical Psychologist
  • Richardson, TX
National Provider Identifier
1447544812
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
22116 Issued in TX
Legal business name
BERNARD J. GOTWAY, PH.D., P.C.
Practice address
1701 Gateway Blvd
Ste 447
Richardson, TX 75080-3572
Phone
(972) 918-9333
Fax
(972) 783-8444
NPI assigned
Jun 2, 2011
Last updated
Jun 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2011

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

Authorized official

Name
Dr. Bernard J. Gotway, PH.D.NPI 1396721700
Title
President / Owner
Phone
(972) 918-9333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 22116 TX Primary

Addresses

Primary practice location

1701 Gateway Blvd
Ste 447
Richardson, TX 75080-3572

Mailing address

1701 Gateway Blvd
Ste 447
Richardson, TX 75080-3572
Phone (972) 918-9333

National Provider Directory

National Provider Directory

Locations

1701 Gateway Blvd
Ste 405
Richardson, TX 75080
Phone (972) 918-9333

1701 Gateway Blvd
Ste 44
Richardson, TX 75080

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1447544812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 GATEWAY BLVD",
            "address_2": "STE 447",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803572",
            "telephone_number": "972-918-9333",
            "fax_number": "972-783-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 GATEWAY BLVD",
            "address_2": "STE 447",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803572",
            "telephone_number": "972-918-9333",
            "fax_number": "972-783-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNARD J. GOTWAY, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "GOTWAY",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "972-918-9333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "22116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.