Healthcare Provider Details

I. General information

NPI: 1427380377
Provider Name (Legal Business Name): EL RIO PSYCHOLOGICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 W LAMAR ST SUITE 102
SHERMAN TX
75090-5885
US

IV. Provider business mailing address

PO BOX 1154
SHERMAN TX
75091-1154
US

V. Phone/Fax

Practice location:
  • Phone: 903-893-0298
  • Fax: 903-892-6323
Mailing address:
  • Phone: 903-893-0298
  • Fax: 903-892-6323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number25481
License Number StateTX

VIII. Authorized Official

Name: WILLIAM O THOMASON
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 972-841-3987