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General NPI Number Information
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NPI Number | 1821780081
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Entity Type | Individual
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Provider Name | BRYANT KEITH CLAYTON JR. PSYD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 4119 MONTROSE BLVD STE 500
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City | HOUSTON
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State | TX
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Zip | 77006-4970
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Country | US
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Telephone | 317-306-9475
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Fax |
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Provider Business Mailing Address
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Address Line | 8333 BRAESMAIN DR APT 3307
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City | HOUSTON
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State | TX
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Zip | 77025-2956
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Country | US
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Telephone | 317-306-9475
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 39853
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License Number State | TX
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