DR GLENN J BRICKEN AND ASSOC P C
Clinical Neuropsychologist
The Woodlands, Texas
Provider NPI: 1528088077
Organization Information:Organization Name: DR GLENN J BRICKEN AND ASSOC P C
Organization is not Subpart
Authorized Official: GLENN JOSEPH BRICKEN PRESIDENT 281-3640067
Practice Location:
25810 OAK RIDGE DR THE WOODLANDS, TX 77380 US
Tel: 281-364-0067 Fax: 281-364-0712
Business Mailing Address:
25810 OAK RIDGE DR THE WOODLANDS, TX 77380 US
Tel: 281-364-0067 Fax: 281-364-0712
Entity Type: Organization
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Organization is not Subpart
Authorized Official: GLENN JOSEPH BRICKEN PRESIDENT 281-3640067
Practice Location:
25810 OAK RIDGE DR THE WOODLANDS, TX 77380 US
Tel: 281-364-0067 Fax: 281-364-0712
Business Mailing Address:
25810 OAK RIDGE DR THE WOODLANDS, TX 77380 US
Tel: 281-364-0067 Fax: 281-364-0712
Entity Type: Organization
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | ||
Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
084856601 | TX | 05 | |
BCBSTX PIN | 00R65R | TX | 01 |
RAILROAD MEDICARE PIN | CI6064 | TX | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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