Bracken Mental Health a Professional Association.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

K6992 Issued in TX

Legal business name

BRACKEN MENTAL HEALTH A PROFESSIONAL ASSOCIATION.

Doing business as

Bracken Psychiatric Services

Practice address

3200 Southern Dr
#107
Garland, TX 75043-1549

Phone

(972) 278-5385

Fax

(972) 692-8687

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jill W Bracken, D.O.NPI 1710053319

Title

Physician

Phone

(972) 278-5385

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bracken Psychiatric Services Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jill W. Bracken, D.O.

  • Child & Adolescent Psychiatry Physician
  • Garland, TX
  • NPI 1710053319
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1316160807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SOUTHERN DR",
            "address_2": "#107",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431549",
            "telephone_number": "972-278-5385",
            "fax_number": "972-692-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SOUTHERN DR",
            "address_2": "#107",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431549",
            "telephone_number": "972-278-5385",
            "fax_number": "972-692-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRACKEN MENTAL HEALTH A PROFESSIONAL ASSOCIATION.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "BRACKEN",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "972-278-5385",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "K6992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113612904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bracken Psychiatric Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristen Caroline Bowen
• Andrew Steven Bowers
• Ty Jason Bowring, DPT
• Eugenia Bozor
• BQC Home Health Agency, Inc.
• Jill W. Bracken, D.O.
• Robert Wayne Bradley, PSYCHOLOGIST
• Kara Emily Bradshaw, LPC
• David W Bragg, M.D.
• Karol Brandenberger

• Child & Adolescent Psychiatry Physician in Garland, TX
• Providers in Garland, TX by specialty
• Child & Adolescent Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.