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
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
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 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
0012XBOtherTXBCBS TX
287992603MedicaidTX
287992601MedicaidTX
287992602MedicaidTX
DS2658OtherTXRR MCR HARRIS

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

4934 S 7th St
Abilene, TX 79605
Phone (325) 692-2172

6568 Central Park Blvd
Abilene, TX 79606
Phone (325) 400-7760

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

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

554 S Summit Ave
Ft Worth, TX 76104
Phone (817) 336-2593

1600 Texas St
Ft Worth, TX 76102
Phone (817) 338-2400

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

112 Barnett Dr
Lewisville, TX 75077
Phone (330) 867-8530

5915 Elysian Fields Rd
Marshall, TX 75672
Phone (903) 935-6700

825 W Kearney St
Mesquite, TX 75149
Phone (972) 288-7660

2601 NW Loop
Stephenville, TX 76401
Phone (254) 968-4649

Practitioners & affiliated clinicians

Practitioners 110

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "0012XB",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287992603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287992601",
            "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"
        }
    ],
    "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.