Provider Demographics
NPI:1184746653
Name:CARTMELL, BETTY MITCHELL (PHD)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:MITCHELL
Last Name:CARTMELL
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 1:2500 TANGLEWILDE ST
Mailing Address - Street 2:SUITE #350
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2100
Mailing Address - Country:US
Mailing Address - Phone:713-789-4411
Mailing Address - Fax:713-789-4433
Practice Address - Street 1:2500 TANGLEWILDE ST
Practice Address - Street 2:SUITE #350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2100
Practice Address - Country:US
Practice Address - Phone:713-789-4411
Practice Address - Fax:713-789-4433
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-3152103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0985111-01Medicaid
TXG56CMedicare ID - Type UnspecifiedPSYCHOLOGIST