Thomas Wilson Renfroe Jr., PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

24047 Issued in TX

Practice address

2010 Sybil LN
Tyler, TX 75703-1818

Phone

(903) 596-8118

Fax

(903) 596-8125

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

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.

• Jonathan Ridenour, PA

  • Psychologist
  • Tyler, TX
  • NPI 1699233403
  NPD
• Psychology Associates of East Texas, LLC.

  • Mental Health Counselor
  • Tyler, TX
  • NPI 1588061923
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659389617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 SYBIL LN",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031818",
            "telephone_number": "903-596-8118",
            "fax_number": "903-596-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 SYBIL LN",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031818",
            "telephone_number": "903-596-8118",
            "fax_number": "903-596-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENFROE",
        "first_name": "THOMAS",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "24047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86292A",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033724801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renal Center of Waterton, LLLP (Renal Center of Waterton)
• Mark B Renfro, MD
• Devyn Paige Renfroe, PTA
• Haleigh Nicole Renfroe, DDS
• Julee G Renfroe, RN
• Nycole Jeanne Renfrow, RBT
• Rebecca Anne Renfrow, LPC
• Deborah Renneker, LCSW
• Rubyth Renteria, LCSW
• Wendy Reschke

• Psychologist in Tyler, TX
• Providers in Tyler, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.