Individual provider Active NPI

Marian R Zimmerman, PH.D.

  • Clinical Psychologist
  • Frisco, TX
National Provider Identifier
1811330020
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
16829 Issued in TX
Practice address
3550 Parkwood Blvd
Suite 306
Frisco, TX 75034-1903
Phone
(214) 618-1451
NPI assigned
Apr 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 16829 TX Primary
Health Psychologist 103TH0004X 16829 TX

Addresses

Primary practice location

3550 Parkwood Blvd
Suite 306
Frisco, TX 75034-1903

Mailing address

3550 Parkwood Blvd
Suite 306
Frisco, TX 75034-1903
Phone (214) 618-1451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 10, 2024 through Oct 10, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
16829TXMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1811330020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 PARKWOOD BLVD",
            "address_2": "SUITE 306",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750341903",
            "telephone_number": "214-618-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 PARKWOOD BLVD",
            "address_2": "SUITE 306",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750341903",
            "telephone_number": "214-618-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "MARIAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "16829",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "TX",
            "license": "16829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.