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General NPI Number Information
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NPI Number | 1821615733
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Entity Type | Organization
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Legal Business Name | THE CLINIC NEUROPSYCHOLOGICAL & PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 101 UHLAND RD STE 205
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City | SAN MARCOS
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State | TX
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Zip | 78666-6681
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Country | US
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Telephone | 512-392-0710
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Fax | 512-392-0716
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Provider Business Mailing Address
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Address Line | 101 UHLAND RD STE 205
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City | SAN MARCOS
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State | TX
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Zip | 78666-6681
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Country | US
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Telephone | 512-392-0710
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Fax | 512-392-0716
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | WAYNE DEES
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Credential | PSY.D.
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Telephone | 512-392-0710
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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 |
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License Number State |
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