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General NPI Number Information
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NPI Number | 1326329418
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Entity Type | Organization
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Legal Business Name | ALTMAN PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 1200 W MAGNOLIA AVE SUITE 210
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City | FORT WORTH
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State | TX
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Zip | 76104-4481
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Country | US
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Telephone | 817-602-5320
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 W MAGNOLIA AVE SUITE 210
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City | FORT WORTH
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State | TX
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Zip | 76104-4481
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Country | US
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Telephone | 817-602-5320
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL ALTMAN
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Credential | PH.D.
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Telephone | 817-602-5320
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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 | 33637
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License Number State | TX
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