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General NPI Number Information
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NPI Number | 1588150676
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Entity Type | Individual
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Provider Name | TREVOR BIXLER PHD, LP
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Gender | Male
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 8710 FREDERICK ST STE 100
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City | OMAHA
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State | NE
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Zip | 68124-3061
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Country | US
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Telephone | 531-201-6890
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 S TOPAZ WAY
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City | MERIDIAN
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State | ID
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Zip | 83642-4474
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Country | US
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Telephone | 208-605-7070
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Fax |
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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 | 1007
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License Number State | NE
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