Healthcare Provider Details

I. General information

NPI: 1205212610
Provider Name (Legal Business Name): BEWLEY PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2015
Last Update Date: 08/20/2019
Certification Date:
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:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

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