Provider Demographics
NPI:1922109263
Name:O'ROURKE, BRENDAN S (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:S
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 WILCREST DR STE 162
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3391
Mailing Address - Country:US
Mailing Address - Phone:713-266-2261
Mailing Address - Fax:713-266-2212
Practice Address - Street 1:2825 WILCREST DR STE 162
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3391
Practice Address - Country:US
Practice Address - Phone:713-266-2261
Practice Address - Fax:713-266-2212
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22605103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT63LOtherBCBS
TX156305OtherVALUE OPTIONS INSURANCE