Active NPI
Brenda Joyce Wilburn, B.S. M ED
- Psychologist
- Houston, TX
National Provider Identifier
1356654958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 29473
- Practice address
- 11922 Duran Canyon LN
Houston, TX 77067-1047 - Phone
- (281) 748-7383
- NPI assigned
- Jul 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 29473 | TX | Primary |
| School Psychologist | 103TS0200X | 30285 | TX |
Addresses
Primary practice location
11922 Duran Canyon LN
Houston, TX 77067-1047
Mailing address
11922 Duran Canyon LN
Houston, TX 77067-1047
Phone (281) 748-7383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29473 | TX | MD | Psychologist |
| 30285 | TX | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279843200000",
"number": "1356654958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11922 DURAN CANYON LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770671047",
"telephone_number": "281-748-7383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11922 DURAN CANYON LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770671047",
"telephone_number": "281-748-7383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBURN",
"first_name": "BRENDA",
"middle_name": "JOYCE",
"name_prefix": "Ms.",
"credential": "B.S. M ED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-23",
"last_updated": "2010-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "29473",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "TX",
"license": "30285",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.