Healthcare Provider Details

I. General information

NPI: 1538944863
Provider Name (Legal Business Name): GEORGE SCOTT III PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 GREENWAY PLZ STE 1800
HOUSTON TX
77046-2457
US

IV. Provider business mailing address

2415 WYCKCHESTER DR
PEARLAND TX
77584-5968
US

V. Phone/Fax

Practice location:
  • Phone: 832-264-4454
  • Fax:
Mailing address:
  • Phone: 832-270-9646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number39962
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number39962
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number39962
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: