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NPI Code Detail

MEDICARE: LLOYD WHIELDON M.S

MEDICARE: LLOYD WHIELDON M.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist37594TX

General Provider Information

NPI Number : 1639602840
Entity Type Code : Individual
Provider Name (Legal Business Name) : LLOYD WHIELDON M.S
Provider Business Mailing Address
First Line : 10126 LOGAN GROVE CT
Second Line :
City : CONROE
State : TX
Zip : 77302-5270
Country : US
Telephone Number : 936-444-6710
Fax Number :
Provider Business Practice Location Address
First Line : 2219 SAWDUST RD STE 1101
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77380-2580
Country : US
Telephone Number : 936-444-6710
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2017
Last Update Date : 04/05/2017

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Directions to “ LLOYD WHIELDON M.S” Practice Location

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