DR. JERRY L BRYAN (NPI# 1770628216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770628216 |
| Entity Type | Individual |
| Full Name | DR. JERRY L BRYAN |
| Credential | PH.D. |
| Practice Address |
1200 Golden Key Cir #140 El Paso TX 79925-5820 |
| Practice Telephone | 9155989052 |
| Practice Fax Number | 9155983674 |
| Mailing Telephone | 9155989052 |
| Mailing Fax Number | 9155983674 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
21692 | TX | Behavioral Health & Social Service Providers |
| Street Address |
1200 GOLDEN KEY CIR #140 |
| City | EL PASO |
| State | TX |
| Zip Code | 79925-5820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528602117 | Krystal Angelica Puentes | Specialist/Technologist | 1200 Golden Key Cir, El Paso, TX 79925-5820 | 2019-11-06 |
| 1093954539 | Sierra Optical | Technician/Technologist | 1200 Golden Key Cir, Suite 160, El Paso, TX 79925-5820 | 2009-02-06 |
| 1336335843 | Daniel Sida | Technician/Technologist | 1200 Golden Key Cir, Suite 160, El Paso, TX 79925-5820 | 2007-09-18 |
| 1720118771 | Dynamic Change Systems, Inc. | Psychologist | 1200 Golden Key Cir, #140, El Paso, TX 79925-5820 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003434820 | Francisco Andres Escobar | Dentist | 2200 N Yardbrough Dr, Suite N, El Paso, TX 79925 | 2020-07-08 |
| 1982259495 | Cruz Elvia Corral | Assisted Living Facility | 10165 Bermuda, El Paso, TX 79925 | 2019-08-02 |
| 1740846179 | Sister Sisters In Home Care Services LLC | In Home Supportive Care | 9327 Sims Drive, Suite F, El Paso, TX 79925 | 2019-05-10 |
| 1245790450 | Mario Salinas | Student in an Organized Health Care Education/Training Program | 10301 Gateway Blvd W, El Paso, Texas 79925, El Paso, TX 79925 | 2019-03-22 |
| 1720559289 | Sweet Care Home Care Providers LLC | PACE Provider Organization | 7917 Sunmount Dr, El Paso, TX 79925 | 2018-12-10 |
| 1083130215 | Javier Calzadilla Jr. | Behavior Technician | 9900 Montana Ave Ste C6, El Paso, TX 79925 | 2017-08-18 |
| 1942721980 | Isela Cristina Sanchez | Specialist/Technologist | 3021 Killarney St., El Paso, TX 79925 | 2017-06-29 |
| 1831629617 | Rebekah E Alvarez | Behavior Technician | 2200 North Yarabrough Suite B, Apt 103, El Paso, TX 79925 | 2017-06-14 |
| 1841646817 | Imelda Barbosa | Counselor | 9455 Viscount 170, El Paso, TX 79925 | 2016-05-10 |
| 1528426491 | Salnor, Inc. | Clinic/Center | 8517 Lockheed Dr., El Paso, TX 79925 | 2016-02-05 |
| Find all providers in zip 79925 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144727512 | Blake Alexander Riddell | Psychologist | 600 Sunland Park Dr., Bldg. 6, Suite 100, El Paso, TX 79912-7991 | 2018-04-11 |
| 1174911457 | Justin D. Kepple | Psychologist | 8412 Basil Ct, El Paso, TX 79925-3902 | 2015-01-08 |
| 1841637998 | Randall Hampton Rattan | Psychologist | 7717 Lockheed, Suite E, El Paso, TX 79925 | 2013-05-30 |
| 1033553904 | Stacey Richardson | Psychologist | 5005 N. Piedras St, Attn, Wbamc, El Paso, TX 79920-5001 | 2013-04-23 |
| 1659417756 | Sara Beth Bosley | Psychologist | 51000 N. Piedras Street, Room A374, El Paso, TX 79930-4211 | 2007-01-29 |
| 1366592693 | Mario Di Biase | Psychologist | 7001 Westwind Dr Ste 170, El Paso, TX 79912-1778 | 2007-01-11 |
| 1407467780 | Javier Carrillo, Phd. Pllc | Psychologist | 2300 George Dieter Dr, El Paso, TX 79936-3963 | 2020-08-11 |
| 1942773072 | Westwind Psychological Services, Pllc | Psychologist | 7001 Westwind Dr Ste 170, El Paso, TX 79912-1778 | 2019-01-11 |
| 1093281172 | Patrie Cherrelle Williams | Psychologist | 5001 N Piedras St, El Paso, TX 79930-4210 | 2018-10-16 |
| 1043739402 | Melanie Longhurst | Psychologist | 4615 Alameda Ave, El Paso, TX 79905 | 2017-09-16 |
| Find all providers in EL PASO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.