Provider Demographics
NPI:1508172362
Name:CAUDLE, DONALD D (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:D
Last Name:CAUDLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:616 FM 1960 RD W
Mailing Address - Street 2:SUITE 780
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3000
Mailing Address - Country:US
Mailing Address - Phone:281-397-7792
Mailing Address - Fax:281-397-7793
Practice Address - Street 1:616 FM 1960 RD W
Practice Address - Street 2:SUITE 780
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3000
Practice Address - Country:US
Practice Address - Phone:281-397-7792
Practice Address - Fax:281-397-7793
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX31361103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist