Provider Demographics
NPI:1760713614
Name:TEXAS PSYCHOLOGY SERVICE, PLLC
Entity Type:Organization
Organization Name:TEXAS PSYCHOLOGY SERVICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-956-1032
Mailing Address - Street 1:1331 GEMINI ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2745
Mailing Address - Country:US
Mailing Address - Phone:281-956-1032
Mailing Address - Fax:281-956-1040
Practice Address - Street 1:1331 GEMINI
Practice Address - Street 2:SUITE 104
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2745
Practice Address - Country:US
Practice Address - Phone:281-956-1032
Practice Address - Fax:281-956-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32939103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00EE72Medicare UPIN