Active NPI
Michael Brandon, PHD
- Psychologist
- League City, TX
National Provider Identifier
1306958038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- TSBEP 22197
- Practice address
- 620 West Main
Suite 1
League City, TX 77573-3760 - Phone
- (231) 338-2992
- NPI assigned
- Aug 31, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | TSBEP 22197 | TX | Primary |
Addresses
Primary practice location
620 West Main
Suite 1
League City, TX 77573-3760
Mailing address
PO Box 648
League City, TX 77574-0648
Phone (231) 338-2992
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2017 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TSBEP 22197 | TX | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306958038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 648",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775740648",
"telephone_number": "231-338-2992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 WEST MAIN",
"address_2": "SUITE 1",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775733760",
"telephone_number": "231-338-2992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDON",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "TSBEP 22197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in League City, TX
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.