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NPI Code Detail

MEDICARE: EUGENE CHARLES WATERS PHD

MEDICARE:   EUGENE CHARLES WATERS  PHD
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
1103TC2200XClinical Child & Adolescent Psychologist21344TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922048826
Entity Type Code : Individual
Provider Name (Legal Business Name) : EUGENE CHARLES WATERS PHD
Provider Business Mailing Address
First Line : 2027 S 61ST ST
Second Line : STE 126
City : TEMPLE
State : TX
Zip : 76504-6817
Country : US
Telephone Number : 254-493-4559
Fax Number :
Provider Business Practice Location Address
First Line : 2027 S 61ST ST
Second Line : STE 126
City : TEMPLE
State : TX
Zip : 76504-6817
Country : US
Telephone Number : 254-774-8272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 02/23/2016

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Directions to “ EUGENE CHARLES WATERS PHD” Practice Location

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