Healthcare Provider Details

I. General information

NPI: 1932308178
Provider Name (Legal Business Name): TRENT EVERETT & ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11104 W AIRPORT BLVD SUITE 135
STAFFORD TX
77477-3035
US

IV. Provider business mailing address

11104 W AIRPORT BLVD SUITE 135
STAFFORD TX
77477-3035
US

V. Phone/Fax

Practice location:
  • Phone: 832-328-0008
  • Fax:
Mailing address:
  • Phone: 832-328-0008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. TRENTON E. EVERETT
Title or Position: PRESIDENT/LICENSED PSYCHOLOGIST
Credential: PH.D.
Phone: 832-328-0008