Provider Demographics
NPI:1801385927
Name:BALL, GEORGE ALEXANDER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALEXANDER
Last Name:BALL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 N CENTRAL EXPY STE 1820
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-0946
Mailing Address - Country:US
Mailing Address - Phone:214-363-2345
Mailing Address - Fax:
Practice Address - Street 1:5910 N CENTRAL EXPY STE 1820
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-0946
Practice Address - Country:US
Practice Address - Phone:214-363-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37238103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical