Provider Demographics
NPI:1821615733
Name:THE CLINIC NEUROPSYCHOLOGICAL & PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:THE CLINIC NEUROPSYCHOLOGICAL & PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:512-392-0710
Mailing Address - Street 1:101 UHLAND RD STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-6681
Mailing Address - Country:US
Mailing Address - Phone:512-392-0710
Mailing Address - Fax:512-392-0716
Practice Address - Street 1:101 UHLAND RD STE 205
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-6681
Practice Address - Country:US
Practice Address - Phone:512-392-0710
Practice Address - Fax:512-392-0716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty