Provider Demographics
NPI:1275633661
Name:TURNER, DARRELL DUANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:DUANE
Last Name:TURNER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6766
Mailing Address - Country:US
Mailing Address - Phone:713-435-9864
Mailing Address - Fax:281-557-4737
Practice Address - Street 1:419 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6766
Practice Address - Country:US
Practice Address - Phone:713-435-9864
Practice Address - Fax:281-557-4737
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008458103TC0700X
TX33078103TC0700X
IL071004216103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL947020Medicare ID - Type Unspecified