Individual provider Active NPI

William Randolph Billingsley, PH.D.

  • Health Service Psychologist
  • Fort Worth, TX
National Provider Identifier
1750401972
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
2-3146 Issued in TX
Practice address
1810 8TH Ave Ste B-10
Fort Worth, TX 76110-1352
Phone
(817) 688-3788
Fax
(817) 738-8866
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2-3146 TX
Psychologist 103T00000X 2-3146 TX
Health Service Psychologist 103TH0100X 2-3146 TX Primary

Addresses

Primary practice location

1810 8TH Ave Ste B-10
Fort Worth, TX 76110-1352

Mailing address

1810 8TH Ave Ste B-10
Fort Worth, TX 76110-1352
Phone (817) 688-3788

Other identifiers 1

IdentifierTypeStateIssuer
P00121-E5MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090406000570 TX Practitioner - Clinical Psychologist 7416004585 Practice locations: Fort Worth, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Texas Tech University Health Science Center School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1810 8TH Ave
B 10
Fort Worth, TX 76110-1352
Phone (817) 688-3788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2-3146TXMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1750401972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 8TH AVE STE B-10",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101352",
            "telephone_number": "817-688-3788",
            "fax_number": "817-738-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 8TH AVE STE B-10",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101352",
            "telephone_number": "817-688-3788",
            "fax_number": "817-738-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLINGSLEY",
        "first_name": "WILLIAM",
        "middle_name": "RANDOLPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "2-3146",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "2-3146",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "TX",
            "license": "2-3146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P00121-E5",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.