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General NPI Number Information
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NPI Number | 1275837858
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Entity Type | Individual
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Provider Name | DAVID V NELSON PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 12/22/2010
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Provider Practice Location Address
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Address Line | 919 BEARKAT BLVD PSYCHOLOGICAL SERVICES CENTER
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City | HUNTSVILLE
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State | TX
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Zip | 77340
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Country | US
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Telephone | 936-294-1210
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Fax |
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Provider Business Mailing Address
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Address Line | DEPARTMENT OF PSYCHOLOGY & PHILOSOPHY SHSU BOX 2447
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City | HUNTSVILLE
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State | TX
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Zip | 77341-2447
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Country | US
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Telephone | 936-294-4709
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Fax | 936-294-3798
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 23271
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 23271
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | 23271
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License Number State | TX
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