Active NPI
Thaddeus G Opalach, DO
- Psychiatry Physician
- Mansfield, TX
National Provider Identifier
1598829707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- L8870
- Practice address
- 990 N Walnut Creek Dr
Suite 2014
Mansfield, TX 76063-1580 - Phone
- (817) 453-2223
- Fax
- (817) 453-2269
- NPI assigned
- Dec 21, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | L8870 | TX | Primary |
Addresses
Primary practice location
990 N Walnut Creek Dr
Suite 2014
Mansfield, TX 76063-1580
Mailing address
PO Box 938
Killeen, TX 76540-0938
Phone (254) 634-6999
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255564800000",
"number": "1598829707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 938",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765400938",
"telephone_number": "254-634-6999",
"fax_number": "254-200-4099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 N WALNUT CREEK DR",
"address_2": "SUITE 2014",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760631580",
"telephone_number": "817-453-2223",
"fax_number": "817-453-2269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPALACH",
"first_name": "THADDEUS",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2009-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "L8870",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.