NPIMap

Organization Active NPI

Iris Y. Carrillo, PH.D.

  • Counseling Psychologist
  • Bryan, TX
National Provider Identifier
1326462359
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
36345 Issued in TX
Legal business name
IRIS Y. CARRILLO, PH.D.
Practice address
4103 S Texas Ave Ste 203
Bryan, TX 77802-4043
Phone
(979) 361-7907
Fax
(979) 846-6557
NPI assigned
Feb 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Authorized official

Name
Dr. Iris Ylenia CarrilloNPI 1437586534
Title
Psychologist
Phone
(979) 361-7907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X 36345 TX Primary

Addresses

Primary practice location

4103 S Texas Ave Ste 203
Bryan, TX 77802-4043

Mailing address

4103 S Texas Ave Ste 203
Bryan, TX 77802-4043
Phone (979) 361-7907

National Provider Directory

National Provider Directory

Locations

4103 S Texas Ave
Ste 203
Bryan, TX 77802
Phone (979) 361-7907

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1326462359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 S TEXAS AVE STE 203",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778024043",
            "telephone_number": "979-361-7907",
            "fax_number": "979-846-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 S TEXAS AVE STE 203",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778024043",
            "telephone_number": "979-361-7907",
            "fax_number": "979-846-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRIS Y. CARRILLO, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-11",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "IRIS",
        "authorized_official_middle_name": "YLENIA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "979-361-7907",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "36345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.