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NPI Code Detail

MEDICARE: DR. JOYZELLE HEROD MCCREARY PH.D.

MEDICARE: DR. JOYZELLE HEROD MCCREARY PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist20841TX

General Provider Information

NPI Number : 1003801630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOYZELLE HEROD MCCREARY PH.D.
Provider Business Mailing Address
First Line : 8200 WALNUT HILL LN
Second Line : DEPARTMENT OF PSYCHIATRY
City : DALLAS
State : TX
Zip : 75231-4426
Country : US
Telephone Number : 214-345-7355
Fax Number : 214-345-8753
Provider Business Practice Location Address
First Line : 8200 WALNUT HILL LN
Second Line : DEPARTMENT OF PSYCHIATRY
City : DALLAS
State : TX
Zip : 75231-4426
Country : US
Telephone Number : 214-345-7355
Fax Number : 214-345-8753
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 10/01/2012

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