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DR. JACK L. BODDEN P.H.D.
NPI 1649230814
Psychologist - Clinical in College Station, TX

Active since March 23, 2006
1600 UNIVERSITY DR E, COLLEGE STATION, TX 77840(409) 691-3300 Get Directions Write a Review

NPPES record last updated: July 10, 2007. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Jack L. Bodden P.h.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK L. BODDEN P.H.D. (NPI 1649230814) is an individual clinical provider in College Station, Texas, licensed in Texas (20473) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1649230814
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JACK L. BODDENCredential: P.H.D.
Location Address1600 UNIVERSITY DR ECollege Station, TX 77840-2642
Mailing AddressPo Box 847408Dallas, TX 75284-7408 · (254) 724-2111
Phone(409) 691-3300
Sole ProprietorNo
Enumeration DateMarch 23, 2006
Last NPPES UpdateJuly 10, 2007
✔ NPI 1649230814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in TX · 20473
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1600 UNIVERSITY DR E, College Station, TX 77840
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Other Identifiers 3

Other81078PTX · Blue Shield
Medicare UPINR69683TX
Medicare ID-Type Unspecified81078PTX

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SCOTT & WHITE CLINIC
Clinic/Center (Infusion Therapy)
1600 UNIVERSITY DR E
COLLEGE STATION, TX 77840
Brazos County (409) 691-3300
NERISSA SOOKERMANY-MAHON CCC-SLP
Speech-Language Pathologist
1600 UNIVERSITY DR E
COLLEGE STATION, TX 77840
Brazos County (979) 691-3439
STEVEN PAVLISKA PT
Physical Therapist
1600 UNIVERSITY DR E
COLLEGE STATION, TX 77840
Brazos County (409) 691-3300
DR. KERRY HAMILTON SMITH M.D.
Internal Medicine
1600 UNIVERSITY DR E
COLLEGE STATION, TX 77840
Brazos County (979) 691-3616
SALLY L. MILLER NP
Nurse Practitioner
1600 UNIVERSITY DR E
COLLEGE STATION, TX 77840
Brazos County (409) 691-3300
MRS. MEGAN D SZYHOWSKI
Physical Therapist
1600 UNIVERSITY DR E
COLLEGE STATION, TX 77840
Brazos County (979) 691-3552
DEBRA HANEL PT
Physical Therapist
1600 UNIVERSITY DR E
COLLEGE STATION, TX 77840
Brazos County (409) 691-3300
DR. MANUEL C. JOSE M.D.
Internal Medicine
1600 UNIVERSITY DR E
COLLEGE STATION, TX 77840
Brazos County (409) 691-3300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Bodden's NPI number?

The NPI number for Jack Bodden is 1649230814. It was assigned to this individual provider in the NPPES registry on March 23, 2006.

Where is Jack Bodden located?

Jack Bodden practices at 1600 University Dr E, College Station, TX 77840. The listed phone number is (409) 691-3300.

What is Jack Bodden's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Jack Bodden was last updated on July 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.