Provider Demographics
NPI:1790818037
Name:KEARNS, BRIAN (PHD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:KEARNS
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 1:306 W EDGEWOOD DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4496
Mailing Address - Country:US
Mailing Address - Phone:281-993-1999
Mailing Address - Fax:281-240-6481
Practice Address - Street 1:306 W EDGEWOOD DR
Practice Address - Street 2:SUITE G
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4496
Practice Address - Country:US
Practice Address - Phone:281-993-1999
Practice Address - Fax:281-240-6481
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBCBSOther0031DS
TXBCBSOther0031DS