Bryan David Clarke, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

078823 Issued in IA

Practice address

2106 Treasure Hills Blvd
C/O Mental Health
Harlingen, TX 78550-8736

Phone

(956) 366-4500

NPI assigned

Jul 7, 2011

Last updated

Sep 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1568759819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 TREASURE HILLS BLVD",
            "address_2": "C/O MENTAL HEALTH",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508736",
            "telephone_number": "956-366-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 TREASURE HILLS BLVD",
            "address_2": "C/O MENTAL HEALTH",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508736",
            "telephone_number": "956-366-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "BRYAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "078823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura E Cisneros, MD
• Michael Anthony Cisneros Jr.
• Sharon Cisneros, RN
• Nancy Clark, PHARM.D.
• Stanley D Clark Jr., PSY.D.
• Teresa Diane Clarkston, LVN
• Claudia Perez (Vitalis Wellness & Medspa)
• Claudia R. Jensen , Aprn, FNP-BC, PLLC (Jensen Family Clinic)
• Reynaldo Cleto, LVN
• Esperanza Clinton, PHARM.D

• Clinical Psychologist in Harlingen, TX
• Providers in Harlingen, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.