NPIMap

Organization Active NPI

East Texas Psychological Services

  • Clinical Psychologist
  • Nacogdoches, TX
National Provider Identifier
1619194537
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
21997 Issued in TX
Legal business name
EAST TEXAS PSYCHOLOGICAL SERVICES
Practice address
118 E Hospital St
Suite 300
Nacogdoches, TX 75961-5203
Phone
(936) 564-9875
Fax
(936) 564-1902
NPI assigned
Apr 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Verna L Barron, P.H.D
Title
Owner
Phone
(936) 564-9875

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 21997 TX Primary

Addresses

Primary practice location

118 E Hospital St
Suite 300
Nacogdoches, TX 75961-5203

Mailing address

118 E Hospital St
Suite 300
Nacogdoches, TX 75961-5203
Phone (936) 564-9875

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619194537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E HOSPITAL ST",
            "address_2": "SUITE 300",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759615203",
            "telephone_number": "936-564-9875",
            "fax_number": "936-564-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E HOSPITAL ST",
            "address_2": "SUITE 300",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759615203",
            "telephone_number": "936-564-9875",
            "fax_number": "936-564-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARRON",
        "authorized_official_first_name": "VERNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-564-9875",
        "authorized_official_credential": "P.H.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "21997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.