Provider Demographics
NPI:1003801630
Name:MCCREARY, JOYZELLE HEROD (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOYZELLE
Middle Name:HEROD
Last Name:MCCREARY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 WALNUT HILL LN
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4426
Mailing Address - Country:US
Mailing Address - Phone:214-345-7355
Mailing Address - Fax:214-345-8753
Practice Address - Street 1:8200 WALNUT HILL LN
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4426
Practice Address - Country:US
Practice Address - Phone:214-345-7355
Practice Address - Fax:214-345-8753
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20841103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB163224Medicare PIN
TXTXB163225Medicare PIN
TX00MA09Medicare ID - Type Unspecified
TXTXB163223Medicare PIN