Irvin Pete Brock III, M.D.

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

M1535 Issued in TX

Practice address

10833 N Skyline Dr
Fountain Hills, AZ 85268-6182

Phone

(210) 792-4192

NPI assigned

Jul 26, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Irvin P. Brock III, M.D., P.a.

  • Adult Mental Health Clinic/Center
  • Bulverde, TX
  • NPI 1033145123
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465689600000",
    "number": "1023018678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 N SKYLINE DR",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852686182",
            "telephone_number": "210-792-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 N SKYLINE DR",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852686182",
            "telephone_number": "210-792-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "IRVIN",
        "middle_name": "PETE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2016-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "M1535",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "TX",
            "license": "M1535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinna Bradley, SSP
• Amber Marie Brasington, R.N.
• Julia Marie Braun
• Candace Braxton
• Daniel E Breitenfeldt, PHARMD.
• Madison Anne Brodeur, OTD, OTR/L
• Erin Brophy, OTD
• Bonnie Mae Brown, MS, CCC-SLP
• Creighton Brown
• Karyn D Brown

• Geriatric Psychiatry Physician in Fountain Hills, AZ
• Providers in Fountain Hills, AZ by specialty
• Geriatric Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.