Individual provider Active NPI

Alvin David Farmer Jr., PHD

  • Clinical Psychologist
  • Dallas, TX
National Provider Identifier
1992929830
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37273 Issued in TX
Practice address
3120 N Haskell Ave
Dallas, TX 75204-1510
Phone
(972) 502-4050
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 37273 TX
Clinical Child & Adolescent Psychologist 103TC2200X 37273
Clinical Child & Adolescent Psychologist 103TC2200X 071006599 IL
Clinical Psychologist 103TC0700X 37273 TX Primary

Addresses

Primary practice location

3120 N Haskell Ave
Dallas, TX 75204-1510

Mailing address

1747 W Roosevelt Rd
Chicago, IL 60608-1264
Phone (312) 996-7223

Other practice location 1

1747 W Roosevelt Rd
Chicago, IL 60608-1264
Phone (312) 996-7223

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

LicenseStateTypeSpecialty
37273TXMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Independent School District Clinical PastSince Aug 18, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1992929830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081264",
            "telephone_number": "312-996-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 N HASKELL AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041510",
            "telephone_number": "972-502-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1747 W Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606081264",
            "country_code": "US",
            "telephone_number": "312-996-7223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARMER",
        "first_name": "ALVIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37273",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": "37273",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071006599",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37273",
            "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 Aug 16, 2024; 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.