MEDICARE: DR. STEPHEN K CHOCK 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
1	103G00000X	Clinical Neuropsychologist	2-3764	TX
2	103TC1900X	Counseling Psychologist	2-3764	TX

General Provider Information

NPI Number	:	1356559637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN K CHOCK PH.D.

Provider Business Mailing Address
First Line	:	6821 COLONNADE DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-6319
Country	:	US
Telephone Number	:	972-618-7857
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 GASTON AVE
Second Line	:	NEUROPSYCHOLOGY DEPT.
City	:	DALLAS
State	:	TX
Zip	:	75246-2018
Country	:	US
Telephone Number	:	214-820-9384
Fax Number	:	214-820-9259

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	09/11/2025

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Directions to “ DR. STEPHEN K CHOCK PH.D.” Practice Location

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