NPI age
20 years
Enumerated 2005-10-26
Across 3401 active psychologist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 031788501 | |
| 01 (TX) | 117085 | CHIP PROVIDER NUMBER |
| 01 (TX) | 00T51Y | BC/BS PROVIDER NUMBER |
| 01 (TX) | 115501101 | SWL PROVIDER NUMBER |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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