NPIMap

Organization Active NPI

Mental Health Mental Retardation Authority Brazos Valley

  • Clinic/Center
  • Bryan, TX
National Provider Identifier
1710364153
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MENTAL HEALTH MENTAL RETARDATION AUTHORITY BRAZOS VALLEY
Practice address
1504 S Texas Ave
Bryan, TX 77802-1015
Phone
(979) 822-6467
Fax
(979) 821-9448
NPI assigned
May 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Mr. Bill Kelly
Title
Executive Director
Phone
(979) 822-6467

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

1504 S Texas Ave
Bryan, TX 77802-1015

Mailing address

1504 S Texas Ave
Bryan, TX 77802-1015
Phone (979) 822-6467

Other identifiers 1

IdentifierTypeStateIssuer
1363665MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
MHMR Authority of Brazos Valley5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1710364153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 S TEXAS AVE",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778021015",
            "telephone_number": "979-822-6467",
            "fax_number": "979-821-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 S TEXAS AVE",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778021015",
            "telephone_number": "979-822-6467",
            "fax_number": "979-821-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH MENTAL RETARDATION AUTHORITY BRAZOS VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "979-822-6467",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1363665",
            "state": "TX"
        }
    ],
    "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 17, 2026; 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.