Provider Demographics
NPI:1366155392
Name:BERNARD, DANIEL ROY
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROY
Last Name:BERNARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8665 NEW TRAILS DR STE 185
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4272
Mailing Address - Country:US
Mailing Address - Phone:346-206-3992
Mailing Address - Fax:832-652-3626
Practice Address - Street 1:8665 NEW TRAILS DR STE 185
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-4272
Practice Address - Country:US
Practice Address - Phone:346-206-3992
Practice Address - Fax:832-652-3626
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YP2500X
TX84987101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional