Provider Demographics
NPI:1417989724
Name:DUHON, JAY DANIEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:DANIEL
Last Name:DUHON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:13435 MILL GROVE LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5535
Mailing Address - Country:US
Mailing Address - Phone:214-476-4137
Mailing Address - Fax:972-867-3402
Practice Address - Street 1:2301 OHIO DR
Practice Address - Street 2:STE. 130
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3927
Practice Address - Country:US
Practice Address - Phone:214-476-4137
Practice Address - Fax:972-867-3402
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX23838103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610524900OtherDEPARTMENT OF LABOR
TX00095POtherBLUE CROSS BLUE SHIELD
TX00095POtherBLUE CROSS BLUE SHIELD
TX610524900OtherDEPARTMENT OF LABOR