MEDICARE: DR. PAUL STERLING MCCOLLUM 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	103TC1900X	Counseling Psychologist	20863	TX
2	103TS0200X	School Psychologist	30176	TX

General Provider Information

NPI Number	:	1598777443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL STERLING MCCOLLUM PH.D.

Provider Business Mailing Address
First Line	:	3510 N SAINT MARYS ST
Second Line	:	SUITE 200
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-3164
Country	:	US
Telephone Number	:	210-733-1892
Fax Number	:	210-733-5859

Provider Business Practice Location Address
First Line	:	3510 N SAINT MARYS ST
Second Line	:	SUITE 200
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-3164
Country	:	US
Telephone Number	:	210-733-1892
Fax Number	:	210-733-5859

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	09/11/2025

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