Active NPI
Joseph Mignogna, PH.D.
- Clinical Psychologist
- Tomball, TX
National Provider Identifier
1457757858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301016041
- Practice address
- 24207 Royalwick Dr
Tomball, TX 77375-5136 - Phone
- (405) 269-6866
- NPI assigned
- Nov 12, 2014
- Last updated
- Nov 12, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301016041 | MI | Primary |
| Clinical Psychologist | 103TC0700X | 36973 | TX |
Addresses
Primary practice location
24207 Royalwick Dr
Tomball, TX 77375-5136
Mailing address
24207 Royalwick Dr
Tomball, TX 77375-5136
Phone (405) 269-6866
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301016041 | MI | MD | Clinical Psychologist |
| 36973 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415750400000",
"number": "1457757858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24207 ROYALWICK DR",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773755136",
"telephone_number": "405-269-6866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24207 ROYALWICK DR",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773755136",
"telephone_number": "405-269-6866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIGNOGNA",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-12",
"last_updated": "2014-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301016041",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "36973",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tomball, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.