Individual provider Active NPI

Amber Marie Fahey, PH.D.

  • Clinical Neuropsychologist
  • Jbsa Randolph, TX
National Provider Identifier
1568052702
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0005450 Issued in CO
Practice address
221 3Rd St W BLDG 1040
Jbsa Randolph, TX 78150-4800
Phone
(210) 652-2443
NPI assigned
Jan 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 0005450 CO Primary

Addresses

Primary practice location

221 3Rd St W BLDG 1040
Jbsa Randolph, TX 78150-4800

Mailing address

13006 Larklair St
San Antonio, TX 78233-5016
Phone (619) 681-3534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211013002663 TX Practitioner - Clinical Psychologist 8921406489 Reassigns benefits to 1 organization
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0005450COMDClinical Neuropsychologist
39026TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychological Institute of San Antonio PLLC Clinical Neuropsychologist CurrentSince Nov 18, 2021 Accepting new patients

Locations

19016 Stone Oak Pkwy
Ste 210
San Antonio, TX 78258
Phone (210) 404-9950

19016 Stone Oak Pkwy
San Antonio, TX 78258
Phone (210) 490-0353

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1568052702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13006 LARKLAIR ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782335016",
            "telephone_number": "619-681-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-652-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHEY",
        "first_name": "AMBER",
        "middle_name": "MARIE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "0005450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Randolph, TX

Sources for this page

Verify at the official NPI Registry.