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NPI Code Detail

MEDICARE: BRYAN J. SWEENEY, PH.D., P.C.

MEDICARE: BRYAN J. SWEENEY, PH.D., P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist32939TX

General Provider Information

NPI Number : 1124292875
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRYAN J. SWEENEY, PH.D., P.C.
Provider Business Mailing Address
First Line : 1331 GEMINI ST
Second Line : SUITE 104
City : HOUSTON
State : TX
Zip : 77058-2745
Country : US
Telephone Number : 281-956-1032
Fax Number :
Provider Business Practice Location Address
First Line : 1331 GEMINI ST
Second Line : SUITE 104
City : HOUSTON
State : TX
Zip : 77058-2745
Country : US
Telephone Number : 281-956-1032
Fax Number : 281-956-1040
Authorized Official
Title or Position : PRESIDENT
Name : BRYAN J SWEENEY
Credential : PH.D.
Telephone Number : 281-956-1032
Provider Enumeration Date : 04/14/2008
Last Update Date : 04/14/2008

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