Provider Demographics
NPI:1477607661
Name:DRUMMOND, FREDDIE EUGENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:FREDDIE
Middle Name:EUGENE
Last Name:DRUMMOND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:FRED
Other - Middle Name:
Other - Last Name:DRUMMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1609 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-4425
Mailing Address - Country:US
Mailing Address - Phone:325-944-4722
Mailing Address - Fax:325-223-1150
Practice Address - Street 1:1609 S MONROE ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-4425
Practice Address - Country:US
Practice Address - Phone:325-944-4722
Practice Address - Fax:325-223-1150
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36063103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical