Active NPI
Michel Ange Philippe, PSYD
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1760834758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 37859
- Practice address
- 4500 S Lancaster Rd
Dallas, TX 75216 - Phone
- (214) 857-4916
- NPI assigned
- Jul 1, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | VETPRO | WI | |
| Clinical Psychologist | 103TC0700X | 37859 | TX | Primary |
Addresses
Primary practice location
4500 S Lancaster Rd
Dallas, TX 75216
Mailing address
7900 Churchill Way Apt 9106
Dallas, TX 75251-2040
Phone (786) 266-5972
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VETPRO | WI | MD | Clinical Psychologist |
| 37859 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1760834758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7900 CHURCHILL WAY APT 9106",
"city": "DALLAS",
"state": "TX",
"postal_code": "752512040",
"telephone_number": "786-266-5972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 S LANCASTER RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "75216",
"telephone_number": "214-857-4916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILIPPE",
"first_name": "MICHEL",
"middle_name": "ANGE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-01",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "VETPRO",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "37859",
"primary": true
}
],
"identifiers": [],
"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 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.