MIND BODY WELLNESS PC – Psychologist, NPI 1710929450
Psychologist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MIND BODY WELLNESS PC
7557, Rambler Road, Vickery Meadows PID, Dallas, Dallas County, Texas, 75231, United States
SUITE 814
DALLAS, TX 752314142
Phone: (214) 763-1985
Type: Location
PO BOX 934068
MARGATE, FL 330934068
Phone: (954) 366-2700
Fax: (954) 366-2056
Type: Mailing
17304 PRESTON RD STE 800
DALLAS, TX 752525645
Phone: (972) 849-8987
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-06-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-06-30 (345 days ago).
Enrollment records
1
Earliest due date
2025-06-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040612000347 | O | Clinic/Group Practice | TX | 2025-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75231)
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