Individual provider Active NPI

Roger Brent Worthen, PHD

  • School Psychologist
  • Richmond, TX
National Provider Identifier
1669519575
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
21032 Issued in TX
Practice address
711 S 11TH St
Richmond, TX 77469-3361
Phone
(281) 342-0090
Fax
(281) 341-9388
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 21032 TX
Intellectual & Developmental Disabilities Psychologist 103TM1800X 21032 TX
School Psychologist 103TS0200X 21032 TX Primary

Addresses

Primary practice location

711 S 11TH St
Richmond, TX 77469-3361

Mailing address

4910 Airport Ave
Building D
Rosenberg, TX 77471-5759
Phone (281) 239-1369

Other identifiers 1

IdentifierTypeStateIssuer
86668AOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160226001988 TX Practitioner - Clinical Psychologist 4082919154 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
21032TXMDIntellectual & Developmental Disabilities Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Texana Center CurrentSince Jan 28, 2016 Accepting new patients

Locations

4910 Airport Ave
Ste A
Rosenberg, TX 77471
Phone (281) 239-1300

4910 Airport Ave
Ste D
Rosenberg, TX 77471
Phone (281) 239-1300

4706 Airport Ave
Bldg A
Rosenberg, TX 77471
Phone (281) 238-1800

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1669519575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 AIRPORT AVE",
            "address_2": "BUILDING D",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774715759",
            "telephone_number": "281-239-1369",
            "fax_number": "281-239-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S 11TH ST",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774693361",
            "telephone_number": "281-342-0090",
            "fax_number": "281-341-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHEN",
        "first_name": "ROGER",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "21032",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "TX",
            "license": "21032",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "TX",
            "license": "21032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86668A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.