Organization Active NPI

Sandra Harper PLLC

  • Psychologist
  • Tyler, TX
National Provider Identifier
1578044384
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
24006 Issued in TX
Legal business name
SANDRA HARPER PLLC
Practice address
1820 Shiloh Rd Ste 1503
Tyler, TX 75703-2459
Phone
(903) 596-8118
Fax
(903) 856-8125
NPI assigned
Aug 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Sandra L Harper, PHDNPI 1033127279
Title
President
Phone
(903) 596-8118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 24006 TX Primary

Addresses

Primary practice location

1820 Shiloh Rd Ste 1503
Tyler, TX 75703-2459

Mailing address

17732 Regal Row
Flint, TX 75762-5712

Other identifiers 1

IdentifierTypeStateIssuer
24006OtherTXSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181102001086 TX Part B Supplier - Clinic/Group Practice 5991058240 Receives reassigned benefits from 1 practitioner
Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

1820 Shiloh Rd
Ste 1503
Tyler, TX 75703
Phone (903) 596-8118

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1578044384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17732 REGAL ROW",
            "city": "FLINT",
            "state": "TX",
            "postal_code": "757625712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 SHILOH RD STE 1503",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032459",
            "telephone_number": "903-596-8118",
            "fax_number": "903-856-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA HARPER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-29",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-596-8118",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "24006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "24006",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.