Individual provider Active NPI

Mary Elizabeth Gober, PSY.D.

  • Psychologist
  • Richardson, TX
National Provider Identifier
1821221334
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
34468 Issued in TX
Practice address
1131 Rockingham Dr
Suite 101
Richardson, TX 75080-4354
Phone
(214) 412-9587
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 018114-1 NY
Psychologist 103T00000X 34468 TX Primary

Addresses

Primary practice location

1131 Rockingham Dr
Suite 101
Richardson, TX 75080-4354

Mailing address

1131 N Plymouth Rd
Dallas, TX 75208-3138
Phone (214) 412-9587

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
34468TXMDGeneral Practice Dentistry
018114-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1821221334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 N PLYMOUTH RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752083138",
            "telephone_number": "214-412-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 ROCKINGHAM DR",
            "address_2": "SUITE 101",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750804354",
            "telephone_number": "214-412-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBER",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018114-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "34468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.