Healthcare Provider Details

I. General information

NPI: 1972115939
Provider Name (Legal Business Name): BEWLEY PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 W HICKORY ST STE 304
DENTON TX
76201-4151
US

IV. Provider business mailing address

207 W HICKORY ST STE 304
DENTON TX
76201-4151
US

V. Phone/Fax

Practice location:
  • Phone: 940-294-6789
  • Fax:
Mailing address:
  • Phone: 940-294-6789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARSHALL BEWLEY
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 940-294-6789