Active NPI
Regina Mason Vanburg, PSYD
- Psychologist
- Bandera, TX
National Provider Identifier
1619459930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 090510
- Practice address
- 1211 Cherry St.
Bandera, TX 78003 - Phone
- (210) 663-3116
- NPI assigned
- Sep 4, 2018
- Last updated
- Sep 4, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 090510 | IA | Primary |
Addresses
Primary practice location
1211 Cherry St.
Bandera, TX 78003
Mailing address
PO Box 1414
Bandera, TX 78003-1414
Phone (210) 663-3116
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 090510 | IA | MD | Psychologist |
| 38349 | TX | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crane and the Bull, Corp | Psychologist | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Bandera, TX
- NPI 1205638343
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1619459930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1414",
"city": "BANDERA",
"state": "TX",
"postal_code": "780031414",
"telephone_number": "210-663-3116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 CHERRY ST.",
"city": "BANDERA",
"state": "TX",
"postal_code": "78003",
"telephone_number": "210-663-3116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANBURG",
"first_name": "REGINA",
"middle_name": "MASON",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IA",
"license": "090510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bandera, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.