Individual provider Active NPI

Laura C Minze, PHD

  • Psychologist
  • Dallas, TX
National Provider Identifier
1659723716
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
36879 Issued in TX
Practice address
3500 Oak Lawn Ave Ste 230
Dallas, TX 75219-4369
Phone
(214) 305-2110
NPI assigned
Jul 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 36879 TX Primary

Addresses

Primary practice location

3500 Oak Lawn Ave Ste 230
Dallas, TX 75219-4369

Mailing address

3415 McFarlin Blvd Apt C
Dallas, TX 75205-1866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 24, 2020 through Feb 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
36879TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1659723716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 MCFARLIN BLVD APT C",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752051866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OAK LAWN AVE STE 230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194369",
            "telephone_number": "214-305-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINZE",
        "first_name": "LAURA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.