Active NPI
Thomas Edward Ellis, PSYD
- Psychologist
- Houston, TX
National Provider Identifier
1659736676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 34041
- Practice address
- 12301 Main St
The Menninger Clinic
Houston, TX 77035-6207 - Phone
- (713) 275-5527
- NPI assigned
- Dec 17, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 34041 | TX | Primary |
Addresses
Primary practice location
12301 Main St
The Menninger Clinic
Houston, TX 77035-6207
Mailing address
12301 Main St.
The Menninger Clinic
Houston, TX 77035
Phone (713) 275-5527
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34041 | TX | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450310400000",
"number": "1659736676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12301 MAIN ST.",
"address_2": "THE MENNINGER CLINIC",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77035",
"telephone_number": "713-275-5527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12301 MAIN ST",
"address_2": "THE MENNINGER CLINIC",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770356207",
"telephone_number": "713-275-5527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "THOMAS",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-17",
"last_updated": "2015-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "34041",
"primary": true
}
],
"identifiers": [],
"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 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.