| Kristi Dawn Roper | |
|
17304 Preston Rd Ste 800 Dallas TX 75252-5645 | |
| (214) 763-1985 | |
| Not Available |
| Full Name | Kristi Dawn Roper |
|---|---|
| Speciality | Psychologist |
| Location | 17304 Preston Rd Ste 800, Dallas, Texas |
| Authorized Official Name and Position | Kristi D Roper (PROVIDER) |
| Authorized Official Contact | 2147631985 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristi Dawn Roper 17304 Preston Rd Ste 800 Dallas TX 75252-5645 Ph: (214) 763-1985 | Kristi Dawn Roper 17304 Preston Rd Ste 800 Dallas TX 75252-5645 Ph: (214) 763-1985 |
| NPI Number | 1457650277 |
|---|---|
| Provider Enumeration Date | 03/18/2011 |
| Last Update Date | 11/01/2021 |
| Certification Date | 11/01/2021 |
| Medicare PECOS PAC ID | 1052718111 |
|---|---|
| Medicare Enrollment ID | O20210916002024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457650277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 30752 (Texas) | Primary |
| Provider Name | Kristi D Roper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508807207 PECOS PAC ID: 2466435029 Enrollment ID: I20040612000710 |
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