Texas Traumatic Brain Injury Rehab

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

TEXAS TRAUMATIC BRAIN INJURY REHAB

Practice address

214 W. Colorado Blvd.
Dallas, TX 75208

Phone

(214) 943-9431

Fax

(214) 943-9407

NPI assigned

Dec 7, 2016

Organization subpart

No

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

Authorized official

Name

Linda Riley

Title

Admin

Phone

(214) 943-9431

Specialties & licenses 6

Addresses

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1659815892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 226656",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75222",
            "telephone_number": "214-943-9431",
            "fax_number": "214-943-9407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W. COLORADO BLVD.",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75208",
            "telephone_number": "214-943-9431",
            "fax_number": "214-943-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS TRAUMATIC BRAIN INJURY REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "214-943-9431"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.