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General NPI Number Information
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NPI Number | 1063560654
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Entity Type | Organization
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Legal Business Name | R. P. YURCHESHEN, PH.D., P.C.
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 6391 DE ZAVALA RD STE 203C
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City | SAN ANTONIO
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State | TX
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Zip | 78249-2143
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Country | US
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Telephone | 210-734-6668
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Fax | 210-734-6660
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Provider Business Mailing Address
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Address Line | 6391 DE ZAVALA RD STE 203C
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City | SAN ANTONIO
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State | TX
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Zip | 78249-2159
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Country | US
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Telephone | 210-734-6668
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Fax | 210-734-6660
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD PAUL YURCHESHEN
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Credential | PH.D.
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Telephone | 210-734-6668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 21782
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License Number State | TX
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