Healthcare Provider Details

I. General information

NPI: 1881717684
Provider Name (Legal Business Name): HOWARD GRAY ATKINS JR. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2007
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 COIT RD SUITE C
PLANO TX
75075-3731
US

IV. Provider business mailing address

2419 COIT RD SUITE C
PLANO TX
75075-3731
US

V. Phone/Fax

Practice location:
  • Phone: 972-612-9787
  • Fax: 972-867-2722
Mailing address:
  • Phone: 972-612-9787
  • Fax: 972-867-2722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number22090
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number22090
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number22090
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number22090
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number22090
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number22090
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number22090
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number22090
License Number StateTX
# 9
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number22090
License Number StateTX
# 10
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number22090
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: