Provider Demographics
NPI:1609070689
Name:JOULES, SHAALON (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHAALON
Middle Name:
Last Name:JOULES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 MAIN ST
Mailing Address - Street 2:STE. 281
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4302
Mailing Address - Country:US
Mailing Address - Phone:469-328-6473
Mailing Address - Fax:888-908-9549
Practice Address - Street 1:2770 MAIN ST
Practice Address - Street 2:STE. 281
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4302
Practice Address - Country:US
Practice Address - Phone:469-328-6473
Practice Address - Fax:888-908-9549
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34129103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB112670Medicare PIN
TXTXB112671Medicare PIN
TX614391Medicare PIN