Healthcare Provider Details

I. General information

NPI: 1992982524
Provider Name (Legal Business Name): GALE MINCHEW PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2008
Last Update Date: 06/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S CENTRAL ST
HALLSVILLE TX
75650-6048
US

IV. Provider business mailing address

311 S CENTRAL ST
HALLSVILLE TX
75650-6048
US

V. Phone/Fax

Practice location:
  • Phone: 903-235-5862
  • Fax: 903-668-4376
Mailing address:
  • Phone: 903-235-5862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number33793
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number33793
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: