Active NPI
Jack Greeson, PHD
- Psychologist
- Victoria, TX
National Provider Identifier
1073579496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6484
- Practice address
- 5606 N Navarro
Ste 209
Victoria, TX 77904 - Phone
- (361) 578-9190
- Fax
- (361) 578-9206
- NPI assigned
- Apr 25, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 22550 | TX | |
| Psychologist | 103T00000X | 6484 | TX | Primary |
Addresses
Primary practice location
5606 N Navarro
Ste 209
Victoria, TX 77904
Mailing address
PO Box 4953
Victoria, TX 77903
Phone (361) 578-9190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6484 | TX | MD | Psychologist |
| 22550 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jack Greeson PHD & Associates PC | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1073579496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4953",
"city": "VICTORIA",
"state": "TX",
"postal_code": "77903",
"telephone_number": "361-578-9190",
"fax_number": "361-578-9206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5606 N NAVARRO",
"address_2": "STE 209",
"city": "VICTORIA",
"state": "TX",
"postal_code": "77904",
"telephone_number": "361-578-9190",
"fax_number": "361-578-9206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREESON",
"first_name": "JACK",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "22550",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "6484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victoria, TX
- Jack D Gray, FNP
- Greater Texas Spine & Neurosurgery PA
- Cheryl Ann Green, MSW, LCSW
- Clatyon Green
- Stacey Michelle Greer, LPC-A
- Julane Gregory, NP-C
- Carolina Espinoza Griffin, FNP
- Grovers Emergency Medicine Associates, PA
- Grovers Physician Services, PA
- Guadalupe County Hospital Board (The Courtyard Rehabilitation and Healthcare Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.