Provider Demographics
NPI:1346347556
Name:GREENWOOD PSYCHOLOGICAL SERVICES PC
Entity Type:Organization
Organization Name:GREENWOOD PSYCHOLOGICAL SERVICES PC
Other - Org Name:CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-444-2208
Mailing Address - Street 1:2611 FM 1960 WEST
Mailing Address - Street 2:SUITE D101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068
Mailing Address - Country:US
Mailing Address - Phone:281-444-2208
Mailing Address - Fax:281-363-9475
Practice Address - Street 1:2611 FM 1960 WEST
Practice Address - Street 2:SUITE D101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068
Practice Address - Country:US
Practice Address - Phone:281-444-2208
Practice Address - Fax:281-363-9475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22865103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
R58309Medicare UPIN
00JD99Medicare ID - Type Unspecified