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

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

Organization subpart

No

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.

Title

President / Owner

Phone

(972) 918-9333

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032366901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James David Benning, OD
• Mattea Bentley
• Adam Miles Berenson, MD
• Lydia Berger
• Rebecca L Bergthold, MS, LPC
• Lindsey Bernard, WHNP-BC
• Katlyn Elizabeth Berry, PT, DPT
• Amir Beshir
• Beth Coles Therapy, PLLC
• Sarah Jospehine Beutler

• Clinical Psychologist in Richardson, TX
• Providers in Richardson, TX by specialty
• Clinical Psychologist in Texas

• 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.