Active NPI
Bryant Keith Clayton Jr., PSYD
- Clinical Psychologist
- Houston, TX
National Provider Identifier
1821780081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 39853
- Practice address
- 4119 Montrose Blvd Ste 500
Houston, TX 77006-4970 - Phone
- (317) 306-9475
- NPI assigned
- May 24, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 39853 | TX | Primary |
Addresses
Primary practice location
4119 Montrose Blvd Ste 500
Houston, TX 77006-4970
Mailing address
8333 Braesmain Dr Apt 3307
Houston, TX 77025-2956
Phone (317) 306-9475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39853 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deep Eddy Psychotherapy Management, LLC | Clinical | Current | Accepting new patients |
Locations
4119 Montrose Blvd
Ste 500
Houston, TX 77006
Phone (512) 456-9183
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": "1684886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684886400000",
"number": "1821780081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8333 BRAESMAIN DR APT 3307",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770252956",
"telephone_number": "317-306-9475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4119 MONTROSE BLVD STE 500",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770064970",
"telephone_number": "317-306-9475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAYTON",
"first_name": "BRYANT",
"middle_name": "KEITH",
"name_suffix": "Jr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-24",
"last_updated": "2023-05-24",
"certification_date": "2023-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "39853",
"primary": true
}
],
"identifiers": [],
"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 May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.