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General NPI Number Information
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NPI Number | 1245339753
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Entity Type | Individual
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Provider Name | WILLIAM ALLEN WANDELL PHD
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2439 SUNSET BLVD
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City | HOUSTON
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State | TX
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Zip | 77005-1431
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Country | US
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Telephone | 713-729-0472
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Fax | 713-729-9927
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Provider Business Mailing Address
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Address Line | 5418 QUEENSLOCH DR
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City | HOUSTON
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State | TX
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Zip | 77086-4028
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Country | US
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Telephone | 713-729-0472
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Fax | 713-729-9927
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 200218
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License Number State | TX
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