Provider Demographics
NPI:1891269627
Name:PROPSYCH PLLC
Entity Type:Organization
Organization Name:PROPSYCH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSSLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:832-425-8363
Mailing Address - Street 1:1503 PALO DURO CANYON DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6498
Mailing Address - Country:US
Mailing Address - Phone:832-425-8363
Mailing Address - Fax:
Practice Address - Street 1:1503 PALO DURO CANYON DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6498
Practice Address - Country:US
Practice Address - Phone:832-425-8363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty