MEDICARE: DR. WILLIAM CLAUDE WHITEHEAD PH. D.

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
1	103TC0700X	Clinical Psychologist	23291	TX

General Provider Information

NPI Number	:	1669457149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM CLAUDE WHITEHEAD PH. D.

Provider Business Mailing Address
First Line	:	5232 VILLAGE CREEK DR
Second Line	:	SUITE 200
City	:	PLANO
State	:	TX
Zip	:	75093-4437
Country	:	US
Telephone Number	:	972-818-3993
Fax Number	:	972-250-3644

Provider Business Practice Location Address
First Line	:	5232 VILLAGE CREEK DR
Second Line	:	SUITE 200
City	:	PLANO
State	:	TX
Zip	:	75093-4437
Country	:	US
Telephone Number	:	972-818-3993
Fax Number	:	972-250-3644

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	12/10/2009

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