Active NPI
Nicholas Edd, PSY.D
- Psychologist
- Houston, TX
National Provider Identifier
1629131024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 23060
- Practice address
- 11767 Katy Fwy
Suite 715
Houston, TX 77079-1716 - Phone
- (281) 558-6231
- Fax
- (281) 558-6379
- NPI assigned
- Dec 18, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 23060 | TX | Primary |
Addresses
Primary practice location
11767 Katy Fwy
Suite 715
Houston, TX 77079-1716
Mailing address
PO Box 66118
Houston, TX 77266-6118
Phone (281) 558-6231
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0856049-01 | Medicaid | TX |
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23060 | TX | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210204800000",
"number": "1629131024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 66118",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772666118",
"telephone_number": "281-558-6231",
"fax_number": "281-558-6379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11767 KATY FWY",
"address_2": "SUITE 715",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770791716",
"telephone_number": "281-558-6231",
"fax_number": "281-558-6379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDD",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2008-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "23060",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0856049-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.