DAVENPORT DIAGNOSTIC AND TREATMENT CENTER, INC (NPI# 1255578191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255578191 |
| Entity Type | Organization |
| Organization Name | DAVENPORT DIAGNOSTIC AND TREATMENT CENTER, INC |
| Practice Address |
14275 Midway Rd Suite 220 Addison TX 75001-3614 |
| Practice Telephone | 9728500720 |
| Mailing Telephone | 9728500720 |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |
| Authorized Official Name | DR. KIMBERLY C JOHNSON (PSYCOLOGIST) |
| Authorized Official Telephone | 9728500720 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TS0200X |
Psychologist Specialization: School |
32698 | TX | Behavioral Health & Social Service Providers |
| Y | 103G00000X | Clinical Neuropsychologist | 32578 | TX | Behavioral Health & Social Service Providers |
| Street Address |
14275 MIDWAY RD SUITE 220 |
| City | ADDISON |
| State | TX |
| Zip Code | 75001-3614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437135506 | Eric A. Albright | Pathology | 14275 Midway Rd, Suite 400, Addison, TX 75001-3614 | 2005-12-20 |
| 1548565989 | St James Hospice,llc | Hospice Care, Community Based | 14275 Midway Rd, # 220, Addison, TX 75001-3614 | 2011-01-16 |
| 1861702037 | Texas Visiting Doctors Management LLC | Family Medicine | 14275 Midway Rd, Suite 220, Addison, TX 75001-3614 | 2010-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143772 | Naomi Grace Moats | Speech-Language Pathologist | 5820 Addison Rd, Addison, TX 75001 | 2020-01-22 |
| 1669020467 | Us Med, LLC | Durable Medical Equipment & Medical Supplies | 15455 Dallas Parkway, Suite 600; Office #6015, Addision, TX 75001 | 2019-08-27 |
| 1316592215 | Sunny Boy Pharmacy, LLC | Pharmacy | 4388 Sunbelt Dr, Addision, TX 75001 | 2019-08-07 |
| 1538714779 | Tarpon Pllc | Physical Medicine & Rehabilitation | 17051 N. Dallas Parkway, Suite 320, Addison, TX 75001 | 2019-08-05 |
| 1235782251 | Aliah T Green | Speech-Language Pathologist | 15820 Addison Road, Addison, TX 75001 | 2019-07-18 |
| 1902376254 | Kendall Leann Chambers | Counselor | 15851 Dallas Parkway, Suite 600, Addison, TX 75001 | 2018-11-29 |
| 1053800391 | U S Anesthesia Partners of Texas, Pa | Physician Assistant | 17051 Dallas Pkwy Ste 310, Addison, TX 75001 | 2018-05-02 |
| 1528561719 | Relinda Lee Longan | Licensed Vocational Nurse | 4820 Westgrove Dr, # 903, Addison, TX 75001 | 2018-03-14 |
| 1306363338 | Margaret Weiss | Social Worker | Steven A Cohen Military Family Clinic At Metrocare, 16160 Midway Rd, Suite 218, Addison, TX 75001 | 2017-08-30 |
| 1508380759 | Dallas Sci Recovery Inc | Clinic/Center | 15046 Beltway Dr, Addison, TX 75001 | 2017-07-31 |
| Find all providers in zip 75001 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427483288 | Natalie Friedrich | Clinical Neuropsychologist | 14675 Midway Rd Ste 208, Addison, TX 75001-3907 | 2013-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598375487 | Tara Austin | Clinical Neuropsychologist | 4900 Bagby Ave Apt 819, Waco, TX 76711-0035 | 2020-08-05 |
| 1215557400 | Amy Elizabeth Werry | Clinical Neuropsychologist | 7703 Floyd Circle Drive, San Antonio, TX 78229 | 2020-04-17 |
| 1992330864 | Annelizabeth Robinson Carlew | Clinical Neuropsychologist | 6333 Forest Park Rd 1st Fl Bla.100, Dallas, TX 75390-5461 | 2020-03-11 |
| 1710511753 | Gulf Coast Neuropsychology, Pllc | Clinical Neuropsychologist | 1110 Nasa Pkwy Ste 108c, Houston, TX 77058-3351 | 2020-02-28 |
| 1356988372 | Jennifer Reynolds | Clinical Neuropsychologist | 8005 Canyon Parke Ct, Austin, TX 78726-4029 | 2019-12-09 |
| 1649835216 | Kaleidoscope Counseling and Assessment | Clinical Neuropsychologist | 1705 S Capital of Texas Hwy Ste 130, Austin, TX 78746-6587 | 2019-05-08 |
| 1104392067 | Neuropsychological Services of Texarkana Pllc | Clinical Neuropsychologist | 5411 Plaza Dr Ste E, Texarkana, TX 75503-1667 | 2018-10-18 |
| 1801370184 | Professional Exam Services Inc. | Clinical Neuropsychologist | 2233 E Grauwyler Rd Ste 107, Irving, TX 75061-3239 | 2018-09-21 |
| 1255815072 | Seema Pandya | Clinical Neuropsychologist | 9101 N Central Expy Ste 230, Dallas, TX 75231-6079 | 2018-09-18 |
| 1972097145 | Juliette Galindo | Clinical Neuropsychologist | 1333 Moursund Ave, Psychology/neuropsychology H124, Houston, TX 77030-3405 | 2018-06-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.