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NPI Code Detail

MEDICARE: DR. GEORGE TOBIAS HASLAM-HOPWOOD PSYD

MEDICARE: DR. GEORGE TOBIAS HASLAM-HOPWOOD PSYD
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
1103TC0700XClinical Psychologist32239TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
132239OTHERTXTEXAS LICENSE

General Provider Information

NPI Number : 1912105131
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE TOBIAS HASLAM-HOPWOOD PSYD
Provider Business Mailing Address
First Line : 2801 GESSNER DR
Second Line :
City : HOUSTON
State : TX
Zip : 77080-2503
Country : US
Telephone Number : 713-275-5218
Fax Number : 713-333-0172
Provider Business Practice Location Address
First Line : 2801 GESSNER DR
Second Line :
City : HOUSTON
State : TX
Zip : 77080-2503
Country : US
Telephone Number : 713-275-5218
Fax Number : 713-333-0172
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2007
Last Update Date : 07/10/2007

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