Chris Michael Vicente, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

M3414 Issued in TX

Practice address

1207 Arista Dr
Ste 103
Rockwall, TX 75032-6657

Phone

(214) 703-1900

Fax

(214) 703-1901

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jessela D. Tan, M.D., P.L.L.C.

  • Family Medicine Physician
  • Rowlett, TX
  • NPI 1841451481
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1760442750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3523 MCKINNEY AVE",
            "address_2": "STE 735",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041401",
            "telephone_number": "214-703-1900",
            "fax_number": "214-703-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 ARISTA DR",
            "address_2": "STE 103",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326657",
            "telephone_number": "214-703-1900",
            "fax_number": "214-703-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENTE",
        "first_name": "CHRIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME82475",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "M3414",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "TX",
            "license": "M3414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264998500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John David Vecchio
• Kristen Velasquez, LPC
• Katherine Scarlette Ventura
• Versailles Health and Wellness Clinic, LLC
• Versailles Health and Wellness PLLC
• Gabriela Vigueras
• Junefe Asuan Villania, PT
• Carol Kitay Villanueva, DO
• Alyssa Rae Villarreal
• Eliud Villarreal, DDS

• Neurology Physician in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Neurology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.