Jacklin G Tawadrous, PHD, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

37396 Issued in TX

Practice address

16441 Space Center Blvd # C-100
Houston, TX 77058-2015

Phone

(281) 480-7554

Fax

(281) 480-4193

NPI assigned

Aug 5, 2010

Last updated

Feb 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Carole and Ronald Krist Samaritan Counseling CenterGroup PAC ID 8325274152, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carole and Ronald Krist Samaritan Counseling Center

  • Counseling Psychologist
  • Houston, TX
  • NPI 1689690083
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1730493479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16441 SPACE CENTER BLVD # C-100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582015",
            "telephone_number": "281-480-7554",
            "fax_number": "281-480-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16441 SPACE CENTER BLVD # C-100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582015",
            "telephone_number": "281-480-7554",
            "fax_number": "281-480-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWADROUS",
        "first_name": "JACKLIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Lee Tavel, M.D.
• Gabriella Orobosa Tavera, MD
• Sara Ines Taveras Alam, M.D.
• Tiffany Ann Tavernier, M.D., M.S.P.H.
• Noemi Vega Tavira
• Tawakkol Surgical, LLC
• Samer Tawakkol, MD
• Hussein Abdul-Hassan Tawbi, MD
• Ursula Tawbi, M.D.
• Shweta A Tawde, BDS,MSD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.