Miguel L Desocarraz Jr., PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

21513 Issued in TX

Practice address

503 Lakewood St
Rockport, TX 78382-6958

Phone

(361) 779-6472

Fax

(361) 729-1467

NPI assigned

Oct 10, 2005

Last updated

Jul 28, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1760470249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 LAKEWOOD ST",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783826958",
            "telephone_number": "361-779-6472",
            "fax_number": "361-729-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 LAKEWOOD ST",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783826958",
            "telephone_number": "361-779-6472",
            "fax_number": "361-729-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESOCARRAZ",
        "first_name": "MIGUEL",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "21513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX",
            "identifier": "00HR73",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033905301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Irvin Corre, PMHNP
• Lincoln Wayne Davis, PTA
• Erlinda Devera, MD
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• Ladislav Doupnik, M.D.
• Dr. Melecio F Apostol M.D.
• Dr. Mitchel L. Wess, PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.