NPIMap

Organization Active NPI

Dynamic Change Systems, Inc.

  • Clinical Psychologist
  • El Paso, TX
National Provider Identifier
1720118771
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2-1632 Issued in TX
Legal business name
DYNAMIC CHANGE SYSTEMS, INC.
Practice address
1200 Golden Key Cir
#140
El Paso, TX 79925-5820
Phone
(915) 598-9052
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gerald L. Bryan, PH.D.
Title
President
Phone
(915) 598-9052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 2-1632 TX Primary

Addresses

Primary practice location

1200 Golden Key Cir
#140
El Paso, TX 79925-5820

Mailing address

1200 Golden Key Cir
#140
El Paso, TX 79925-5820
Phone (915) 598-9052

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720118771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GOLDEN KEY CIR",
            "address_2": "#140",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799255820",
            "telephone_number": "915-598-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GOLDEN KEY CIR",
            "address_2": "#140",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799255820",
            "telephone_number": "915-598-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC CHANGE SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRYAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "915-598-9052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "2-1632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.