Andrea Wahlberg, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

37231 Issued in TX

Practice address

7601 Preston Rd
Suite P4300
Plano, TX 75024-3214

Phone

(469) 303-4090

NPI assigned

Jul 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Health System of Texas

  • Children's Hospital
  • Dallas, TX
  • NPI 1194743013
  Medicare reassignment NPD
• Children'S Health System of Texas

  • Community/Retail Pharmacy
  • Dallas, TX
  • NPI 1881830602
  NPD

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1639522253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 PRESTON RD",
            "address_2": "SUITE P4300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243214",
            "telephone_number": "469-303-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 PRESTON RD",
            "address_2": "SUITE P4300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243214",
            "telephone_number": "469-303-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLBERG",
        "first_name": "ANDREA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "37231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Wade, LPC
• Alyssa Bugg Wade, MS, CCC-SLP
• Brynn Wendy Waggoner, SLP
• Mark Bennett Waggoner, DDS
• Hayley Wagner
• Tracey Wahlenmaier
• Charles Njuguna Wainaina, FNP-C
• Jada Marie Wainright
• Hailey Vaughan Hundley Wakefield, M.S. CCC-SLP
• Fadia Wakim

• Clinical Neuropsychologist in Plano, TX
• Providers in Plano, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.