Provider Demographics
NPI:1497551998
Name:NALL, TODD DOUGLAS
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:DOUGLAS
Last Name:NALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 RALEIGH DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-3735
Mailing Address - Country:US
Mailing Address - Phone:210-683-8034
Mailing Address - Fax:
Practice Address - Street 1:5206 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4420
Practice Address - Country:US
Practice Address - Phone:281-426-0397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional