NPIMap

Organization Active NPI

Senior Psychological Care Dallas I, LLC

  • Psychologist
  • Houston, TX
National Provider Identifier
1649566795
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SENIOR PSYCHOLOGICAL CARE DALLAS I, LLC
Practice address
4635 Southwest Fwy Ste 635
Houston, TX 77027-7112
Phone
(713) 850-0049
Fax
(713) 627-7302
NPI assigned
Jun 27, 2011
Last updated
Dec 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Authorized official

Name
Randall J. Frapart, CPA
Title
Chief Financial Officer
Phone
(713) 850-0049

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X
Psychologist 103T00000X Primary
Clinical Psychologist 103TC0700X
Social Worker 104100000X
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

4635 Southwest Fwy Ste 635
Houston, TX 77027-7112

Mailing address

4635 Southwest Fwy Ste 635
Houston, TX 77027-7112
Phone (713) 850-0049

Other identifiers 5

IdentifierTypeStateIssuer
287992601MedicaidTX
0012XBOtherTXBCBS TX
287992602MedicaidTX
DS2658OtherTXRR MCR HARRIS
287992603MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111114000885 TX Part B Supplier - Clinic/Group Practice 3375717044 Receives reassigned benefits from 108 practitioners

National Provider Directory

National Provider Directory

Locations

600 Maple Ave
Burleson, TX 76028
Phone (817) 295-8118

4517 W State Highway 31
Corsicana, TX 75110
Phone (903) 874-6543

605 W Mulberry St
Decatur, TX 76234
Phone (940) 627-5444

1200 S Hall St
Ennis, TX 75119
Phone (972) 875-9051

1111 Summit Ave
#L
Fort Worth, TX 76102
Phone (817) 877-1199

8600 N Riverside Dr
Fort Worth, TX 76244
Phone (817) 435-1320

6649 N Riverside Dr
Ft Worth, TX 76137
Phone (817) 431-5778

2200 W Upshur Ave
Gladewater, TX 75647
Phone (903) 845-2181

840 N Beaulah St
Hawkins, TX 75765
Phone (903) 769-9105

1109 N 3rd St
Iowa Park, TX 76367
Phone (940) 592-4139

10003 Upland Ave
Lubbock, TX 79424
Phone (806) 224-1644

2501 Sawgrass Dr
San Angelo, TX 76904

817 W Center St
Sherman, TX 75092
Phone (903) 771-1336

Practitioners & affiliated clinicians

Practitioners 110

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 110

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544659200000",
    "number": "1649566795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 SOUTHWEST FWY STE 635",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277112",
            "telephone_number": "713-850-0049",
            "fax_number": "713-627-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4635 SOUTHWEST FWY STE 635",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277112",
            "telephone_number": "713-850-0049",
            "fax_number": "713-627-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR PSYCHOLOGICAL CARE DALLAS I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-27",
        "last_updated": "2018-12-13",
        "status": "A",
        "authorized_official_last_name": "FRAPART",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "713-850-0049",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287992601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "0012XB",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287992602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR HARRIS",
            "identifier": "DS2658",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287992603",
            "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 Dec 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.