Mary Ardis Burnside, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

22199 Issued in TX

Practice address

6750 West Loop South
Bellaire, TX 77401

Phone

(713) 661-9767

Fax

(713) 661-5803

NPI assigned

Oct 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Southwest Psychological Services, P.C.

  • Psychologist
  • Bellaire, TX
  • NPI 1679769962
  NPD (past)

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104902436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 WEST LOOP SOUTH",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "77401",
            "telephone_number": "713-661-9767",
            "fax_number": "713-661-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 WEST LOOP SOUTH",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "77401",
            "telephone_number": "713-661-9767",
            "fax_number": "713-661-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNSIDE",
        "first_name": "MARY",
        "middle_name": "ARDIS",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "22199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shantara Burger
• Thomas David Burgess, D.O.
• Danielle Rose Burget
• Jill Leeder Burk, D.C.
• Marva Davis Burks, LPC
• Gregory Keith Burton, M.D.
• Eniola Buzombo, DNP, FNP-BC
• Haley Elizabeth Cain, OTR, OTD
• Michelle B Calhoun, MA, LPC
• Calo Foot & Ankle Specialists PLLC

• Psychologist in Bellaire, TX
• Providers in Bellaire, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.