Organization Active NPI

Biofeedback & Behavioral Healthcare Solutions, P.a.

  • Clinical Psychologist
  • Dallas, TX
National Provider Identifier
1740451608
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
BIOFEEDBACK & BEHAVIORAL HEALTHCARE SOLUTIONS, P.A.
Practice address
5995 Summerside Dr Unit 795098
Dallas, TX 75379-0092
Phone
(214) 662-0044
NPI assigned
Mar 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Authorized official

Name
Derrick K BlantonNPI 1194830133
Title
Provider
Phone
(214) 662-0044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

5995 Summerside Dr Unit 795098
Dallas, TX 75379-0092

Mailing address

5995 Summerside Dr # 5098
Dallas, TX 75379-0002
Phone (214) 662-0044

Other identifiers 1

IdentifierTypeStateIssuer
170206001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091125000119 TX Part B Supplier - Clinic/Group Practice 3577602911 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
Practice locations: Dallas, TX

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Biofeedback Behavioral Healthcare Solutions PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5000 Quorum Dr
Ste 220
Dallas, TX 75254
Phone (214) 615-6352

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754611200000",
    "number": "1740451608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 SUMMERSIDE DR # 5098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753790002",
            "telephone_number": "214-662-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 SUMMERSIDE DR UNIT 795098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753790092",
            "telephone_number": "214-662-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOFEEDBACK & BEHAVIORAL HEALTHCARE SOLUTIONS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "214-662-0044"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170206001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.