Active NPI
Kathryn Sickorez, M.D.
- Psychiatry Physician
- Dallas, TX
National Provider Identifier
1861652984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- P4907
- Practice address
- 4645 Samuell Blvd
Dallas, TX 75228-6826 - Phone
- (214) 275-7393
- NPI assigned
- Jun 12, 2008
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 245989 | MA | |
| Psychiatry Physician | 2084P0800X | P4907 | TX | Primary |
Addresses
Primary practice location
4645 Samuell Blvd
Dallas, TX 75228-6826
Mailing address
1380 River Bend Dr
Dallas, TX 75247-4914
Phone (214) 743-6159
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 245989 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388016000000",
"number": "1861652984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1380 RIVER BEND DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752474914",
"telephone_number": "214-743-6159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4645 SAMUELL BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752286826",
"telephone_number": "214-275-7393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SICKOREZ",
"first_name": "KATHRYN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-12",
"last_updated": "2013-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "245989",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "P4907",
"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 Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.