Individual provider Active NPI

Bruce Mansbridge, PH.D.

  • Psychologist
  • Austin, TX
National Provider Identifier
1386729911
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
31754 Issued in TX
Practice address
6633 E Hwy 290
Suite 300
Austin, TX 78723-1172
Phone
(512) 327-9494
Fax
(512) 637-5578
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 31754 TX Primary

Addresses

Primary practice location

6633 E Hwy 290
Suite 300
Austin, TX 78723-1172

Mailing address

6633 E Hwy 290
Suite 300
Austin, TX 78723-1158
Phone (512) 327-9494

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
31754TXMDPharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Austinocd Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1386729911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6633 E HWY 290",
            "address_2": "SUITE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231158",
            "telephone_number": "512-327-9494",
            "fax_number": "512-637-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6633 E HWY 290",
            "address_2": "SUITE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231172",
            "telephone_number": "512-327-9494",
            "fax_number": "512-637-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSBRIDGE",
        "first_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "31754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.