Organization Active NPI

Pruedence Brooks, PSYD, PLLC

  • Clinical Psychologist
  • Houston, TX
National Provider Identifier
1811290117
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33885 Issued in TX
Legal business name
PRUEDENCE BROOKS, PSYD, PLLC
Practice address
2000 S Dairy Ashford Rd Ste 380
Houston, TX 77077-5733
Phone
(281) 741-2210
Fax
(281) 741-9734
NPI assigned
Dec 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Dr. Pruedence Brooks, PSYDNPI 1437391836
Title
Owner/Psychologist
Phone
(281) 741-2210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 33885 TX Primary

Addresses

Primary practice location

2000 S Dairy Ashford Rd Ste 380
Houston, TX 77077-5733

Mailing address

2000 S Dairy Ashford Rd Ste 380
Houston, TX 77077-5733
Phone (281) 741-2210

Other identifiers 1

IdentifierTypeStateIssuer
2003766-02MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000752 TX Part B Supplier - Clinic/Group Practice 3779745419 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

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": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1811290117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S DAIRY ASHFORD RD STE 380",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775733",
            "telephone_number": "281-741-2210",
            "fax_number": "281-741-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S DAIRY ASHFORD RD STE 380",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775733",
            "telephone_number": "281-741-2210",
            "fax_number": "281-741-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUEDENCE BROOKS, PSYD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "PRUEDENCE",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "281-741-2210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "33885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003766-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.