NPI 1003626581 · live from the CMS NPI Registry
At4k Texas Providers PLLC
Psychologist, Intellectual & Developmental Disabilities in Grapevine, TX. National Provider Identifier 1003626581, active.
NPI record
| NPI | 1003626581 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Intellectual & Developmental Disabilities 103TM1800X |
| Practice location | 1100 S Main St Ste 103, Grapevine, TX 76051 |
| Practice phone | 817-310-5510 |
| Mailing address | 112 Walnut Blvd Unit 308, Rochester, MI 48307 |
| Enumerated | January 8, 2025 |
| Last updated | February 7, 2025 |
| Authorized official | Chris Tillotson, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Intellectual & Developmental Disabilities primary | 103TM1800X | — |
| Pediatrics, Developmental - Behavioral Pediatrics | 2080P0006X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.