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NPI Code Detail

MEDICARE: PRUEDENCE BROOKS, PSYD, PLLC

MEDICARE: PRUEDENCE BROOKS, PSYD, PLLC
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 Psychologist33885TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811290117
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRUEDENCE BROOKS, PSYD, PLLC
Provider Business Mailing Address
First Line : 2000 S DAIRY ASHFORD RD STE 380
Second Line :
City : HOUSTON
State : TX
Zip : 77077-5733
Country : US
Telephone Number : 281-741-2210
Fax Number : 281-741-9734
Provider Business Practice Location Address
First Line : 2000 S DAIRY ASHFORD RD STE 380
Second Line :
City : HOUSTON
State : TX
Zip : 77077-5733
Country : US
Telephone Number : 281-741-2210
Fax Number : 281-741-9734
Authorized Official
Title or Position : OWNER/PSYCHOLOGIST
Name : DR. PRUEDENCE BROOKS
Credential : PSYD
Telephone Number : 281-741-2210
Provider Enumeration Date : 12/08/2010
Last Update Date : 02/05/2024

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