Bryan E Smith, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2-5159 Issued in TX

Practice address

5411 Plaza Dr
Suite E
Texarkana, TX 75503-1666

Phone

(903) 255-0171

Fax

(903) 255-0172

NPI assigned

Oct 7, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Neuropsychological Services of Texarkana PLLC

  • Clinical Neuropsychologist
  • Texarkana, TX
  • NPI 1104392067
  Medicare reassignment NPD Authorized official
• Texarkana Regional Counseling Services

  dba Behavioral Health Center of Texarkana

  • Clinical Social Worker
  • Texarkana, TX
  • NPI 1124031869
  NPD (past)

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1306834015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 PLAZA DR",
            "address_2": "SUITE E",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031666",
            "telephone_number": "903-255-0171",
            "fax_number": "903-255-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 PLAZA DR",
            "address_2": "SUITE E",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031666",
            "telephone_number": "903-255-0171",
            "fax_number": "903-255-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRYAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "2-5159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139710719",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0307068-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Alfred Skinner, M.D.
• Smiley Dental Texarkana
• Amanda Smith, APRN
• Benjamin Levi Smith, P.T., D.P.T.
• Brandy Michelle Smith, FNP
• Cathy Schindler Smith, MD
• Cynthia Jo Smith, MSN, RN
• Dannah M Smith, FNP
• Danni Michele Smith, RN, CA/CP SANE
• Ellen R. Smith, R.PH.

• Clinical Neuropsychologist in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.