Provider Demographics
NPI:1154321149
Name:BRIX, DONALD J (PHD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:BRIX
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3310 LIVE OAK ST
Practice Address - Street 2:BEHAVIORAL HEALTH & SOCIAL SERVICES
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6153
Practice Address - Country:US
Practice Address - Phone:214-266-1222
Practice Address - Fax:214-266-1248
Is Sole Proprietor?:No
Enumeration Date:2005-07-30
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21601103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128577713Medicaid
TX128577716Medicaid
TX128577708Medicaid
TX128577714Medicaid
TX128577707Medicaid
TX128577710Medicaid
TX128577704Medicaid
TX128577706Medicaid
TX128577715Medicaid
TX128577709Medicaid
TX128577711Medicaid
TX128577712Medicaid
TX128577707Medicaid
TX128577715Medicaid