{"npi":"1114285970","type":"NPI-2","status":"active","name":{"display":"East Texas Neurobehavioral Health, PLLC","other":[],"organization_name":"EAST TEXAS NEUROBEHAVIORAL HEALTH,PLLC","authorised_official":"Diane Gard"},"specialty":{"primary_taxonomy":"103TC0700X","primary_taxonomy_description":"Clinical Psychologist","slug":"clinical-psychologist","schema_org_specialty":null,"all":[{"code":"103TC0700X","description":"Clinical Psychologist","primary":true,"state":"TX","license":"33829"}]},"addresses":[{"purpose":"LOCATION","street_1":"122 S GUN BARREL LN","city":"GUN BARREL CITY","state":"TX","postal_code":"751569403","country_code":"US","street_2":"SUITE 6","phone":"9038870697","fax":"9038870698"},{"purpose":"MAILING","street_1":"PO BOX 2107","city":"MABANK","state":"TX","postal_code":"751475017","country_code":"US","phone":"9038870697","fax":"9038870698"}],"license":{"state":"TX","number":"33829"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20120503000151","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"TX","pac_id":"9830351147"}]},"enumeration_date":"2012-05-01","last_updated":"2012-05-01","_meta":{"source":"NPPES","snapshot_date":"2012-05-01","doc_url":"https://findmynpi.com/api"}}