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General NPI Number Information
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NPI Number | 1891751624
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Entity Type | Individual
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Provider Name | JOSEPH EDWIN FOGLE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7557 RAMBLER RD SUITE 711
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City | DALLAS
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State | TX
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Zip | 75231-4142
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Country | US
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Telephone | 214-363-8391
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Fax | 214-363-8316
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Provider Business Mailing Address
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Address Line | 9412 WINDY KNOLL DR
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City | DALLAS
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State | TX
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Zip | 75243-7560
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Country | US
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Telephone | 214-348-2849
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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 | 24389
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License Number State | TX
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