Provider Demographics
NPI:1508974916
Name:HOPER, JOHN H (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:HOPER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 742195
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75374-2195
Mailing Address - Country:US
Mailing Address - Phone:214-503-7428
Mailing Address - Fax:
Practice Address - Street 1:12810 HILLCREST STE 224
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1589
Practice Address - Country:US
Practice Address - Phone:214-503-7428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31238103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029529701Medicaid
TX00082PMedicare ID - Type Unspecified