Individual provider Active NPI

Andrew David Wiese, PHD

  • Psychologist
  • Houston, TX
National Provider Identifier
1235842048
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
39372 Issued in TX
Practice address
Department of Psychiatry and Behavioral Sciences
1977 Butler Blvd
Houston, TX 77030-4101
Phone
(713) 798-3080
NPI assigned
Dec 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 39372 TX
Psychologist 103T00000X 39372 TX Primary

Addresses

Primary practice location

Department of Psychiatry and Behavioral Sciences
1977 Butler Blvd
Houston, TX 77030-4101

Mailing address

Department of Psychiatry and Behavioral Sciences
1977 Butler Blvd
Houston, TX 77030-4101
Phone (713) 798-3080

Other practice location 1

7200 Cambridge St Fl 10
Houston, TX 77030-4202
Phone (713) 798-1750 ext. 2

Other practice location 2

Department of Psychiatry and Behavioral Sciences
1977 Butler Blvd
Houston, TX 77030-4101
Phone (713) 798-3080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230216002261 TX Practitioner - Clinical Psychologist 2466824651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Missouri, Kansas City, School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

7200 Cambridge St
FL 10
Houston, TX 77030-4202
Phone (713) 798-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
39372TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Oct 6, 2022 Accepting new patients
Baylor College of Medicine CurrentSince Oct 6, 2022 Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

1977 Butler Blvd
Houston, TX 77030
Phone (713) 798-4857

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1235842048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES",
            "address_2": "1977 BUTLER BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304101",
            "telephone_number": "713-798-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES",
            "address_2": "1977 BUTLER BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304101",
            "telephone_number": "713-798-3080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Cambridge St Fl 10",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304202",
            "country_code": "US",
            "telephone_number": "713-798-1750 x2",
            "fax_number": "713-798-4693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Department of Psychiatry and Behavioral Sciences",
            "address_2": "1977 Butler Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304101",
            "country_code": "US",
            "telephone_number": "713-798-3080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESE",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-27",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "39372",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "39372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.