Active NPI
Ronique Gordon Wilson, PHD
- Clinical Psychologist
- The Woodlands, TX
National Provider Identifier
1841644564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35002
- Practice address
- 4650 S Panther Creek Dr
The Woodlands, TX 77381-2764 - Phone
- (281) 363-3535
- NPI assigned
- Apr 19, 2016
- Last updated
- Jul 14, 2016
- Sex
- Female
- 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 | 35002 | TX | Primary |
| Counseling Psychologist | 103TC1900X | 35002 | TX |
Addresses
Primary practice location
4650 S Panther Creek Dr
The Woodlands, TX 77381-2764
Mailing address
4715 Viewridge Ave
Suite 230
San Diego, CA 92123-1680
Phone (800) 257-8715
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35002 | TX | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468454400000",
"number": "1841644564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4715 VIEWRIDGE AVE",
"address_2": "SUITE 230",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231680",
"telephone_number": "800-257-8715",
"fax_number": "858-408-7133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 S PANTHER CREEK DR",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773812764",
"telephone_number": "281-363-3535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "RONIQUE",
"middle_name": "GORDON",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-19",
"last_updated": "2016-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "35002",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "35002",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Woodlands, TX
- Willie R Gonzales Jr DDS PC
- Willow Counseling Services, PLLC
- Rhonda Wilson-Dikoko
- Brian Wilson, D.C.
- Krystal I Wilson, M.D.
- Seneca Wilson, OT
- James Winget IV, PT, DPT
- Winnie-Stowell Hospital District (The Woodlands Nursing and Rehabilitation Center)
- Winnie-Stowell Hospital District (Park Manor The Woodlands)
- Vandrikha Wint, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.