Provider Demographics
NPI:1851440630
Name:NELSON, DENNIS EARL (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:EARL
Last Name:NELSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 SPRING PINES DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1128
Mailing Address - Country:US
Mailing Address - Phone:713-213-9249
Mailing Address - Fax:
Practice Address - Street 1:530 N SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE 202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4038
Practice Address - Country:US
Practice Address - Phone:713-213-9249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-0815103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist