Active NPI
Eric J Mariano, PH.D.
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1538267455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 31123
- Practice address
- 4500 S Lancaster Rd
Vanthcs (116a)
Dallas, TX 75216-7167 - Phone
- (214) 857-0835
- Fax
- (214) 857-0902
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 31123 | TX | Primary |
Addresses
Primary practice location
4500 S Lancaster Rd
Vanthcs (116a)
Dallas, TX 75216-7167
Mailing address
4500 S Lancaster Rd
Vanthcs (116a)
Dallas, TX 75216-7167
Phone (214) 857-0835
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 |
|---|---|---|---|
| 31123 | TX | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1538267455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 S LANCASTER RD",
"address_2": "VANTHCS (116A)",
"city": "DALLAS",
"state": "TX",
"postal_code": "752167167",
"telephone_number": "214-857-0835",
"fax_number": "214-857-0902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 S LANCASTER RD",
"address_2": "VANTHCS (116A)",
"city": "DALLAS",
"state": "TX",
"postal_code": "752167167",
"telephone_number": "214-857-0835",
"fax_number": "214-857-0902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIANO",
"first_name": "ERIC",
"middle_name": "J",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "31123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.