Vericare, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

VERICARE, P.C.

Doing business as

Vericare

Practice address

27840 Johnson Rd
Tomball, TX 77375-6455

Phone

(800) 257-8715

Fax

(800) 819-1655

NPI assigned

May 5, 2006

Reactivated

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Melissa King

Title

Director, Credentialing Enrollment

Phone

(800) 370-3651

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Vericare Doing business as

Locations

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499644800000",
    "number": "1992753396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HATCHETTS HILL RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711534",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27840 JOHNSON RD",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773756455",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERICARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2017-07-10",
        "deactivation_date": "2007-04-11",
        "reactivation_date": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING ENROLLMENT",
        "authorized_official_telephone_number": "800-370-3651"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB3582",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136136215",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vericare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Psychologist in Tomball, TX
• Providers in Tomball, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.