Organization Active NPI

Texas Psychological and Consultation Services PLLC

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1689928186
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
TEXAS PSYCHOLOGICAL AND CONSULTATION SERVICES PLLC
Practice address
21031 Market RDG
San Antonio, TX 78258-2483
Phone
(210) 233-6148
Fax
(210) 399-8721
NPI assigned
Nov 5, 2012
Last updated
Jun 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Authorized official

Name
Timothy Kimball, PHD
Title
Manager
Phone
(210) 233-6148

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 34699 TX
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 34699 TX
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X 34699 TX

Addresses

Primary practice location

21031 Market RDG
San Antonio, TX 78258-2483

Mailing address

21031 Market RDG
San Antonio, TX 78258-2483
Phone (210) 233-6148

Other practice location 1

2202 S 77 Sunshinestrip Ste D
Harlingen, TX 78550-8332
Phone (956) 230-4297

Other names 1

  • TPACS Other name

National Provider Directory

National Provider Directory

Locations

21031 Market Rdg
San Antonio, TX 78258
Phone (210) 233-6148

4323 Factory Hill St
San Antonio, TX 78219
Phone (210) 646-1707

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1689928186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21031 MARKET RDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782582483",
            "telephone_number": "210-233-6148",
            "fax_number": "210-399-8721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21031 MARKET RDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782582483",
            "telephone_number": "210-233-6148",
            "fax_number": "210-399-8721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2202 S 77 Sunshinestrip Ste D",
            "address_purpose": "LOCATION",
            "city": "Harlingen",
            "state": "TX",
            "postal_code": "785508332",
            "country_code": "US",
            "telephone_number": "956-230-4297",
            "fax_number": "956-230-1725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS PSYCHOLOGICAL AND CONSULTATION SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "210-233-6148",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "34699",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34699",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "34699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TPACS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "TPACS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.