Dan G Polk, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2-5565 Issued in TX

Practice address

6750 West Loop S
Ste 1000
Bellaire, TX 77401-4105

Phone

(713) 628-4700

NPI assigned

Jun 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dr Glenn J Bricken and Assoc P CGroup PAC ID 8426038027, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Dr Glenn J Bricken & Assoc P C

  • Clinical Psychologist
  • The Woodlands, TX
  • NPI 1528088077
  Medicare reassignment Care Compare group NPD
• Samantha J Vigneri

  • Social Worker
  • Hempstead, TX
  • NPI 1073617684

  Psychologist

  NPD (past)
• Samantha J Vigneri

  • Psychiatry Physician
  • Hempstead, TX
  • NPI 1861420515

  Psychologist

  NPD (past)
• Southwest Psychological Services, P.C.

  • Psychologist
  • Bellaire, TX
  • NPI 1679769962
  NPD (past)
• Utmb Faculty Group Practice

  • General Practice Physician
  • Galveston, TX
  • NPI 1942241146
  NPD (past)

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1942205299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 WEST LOOP S",
            "address_2": "STE 1000",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774014105",
            "telephone_number": "713-628-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 WEST LOOP S",
            "address_2": "STE 1000",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774014105",
            "telephone_number": "713-628-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "DAN",
        "middle_name": "G",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "2-5565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122378602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0091DZ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitchell Charles Pilot, MD
• Dinna Nelly Pineda, M.A., CCC-SLP
• Stacey Raab Pisklak, M.D.
• Stephen T Plant, CO, LO
• Plaza Eye Clinic, PA
• Sarah A. Pollack, PH.D.
• Megan B Pollock, LPC-S, CST
• Rochelle E Pondt, D.O.
• Avery Pope, RBT
• Doris Portillo, RBT

• Psychologist in Bellaire, TX
• Providers in Bellaire, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.