Provider Demographics
NPI:1740520931
Name:SWANHOLM, ERIC NEAL (PHD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:NEAL
Last Name:SWANHOLM
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 1:6509 COUNTRY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-6111
Mailing Address - Country:US
Mailing Address - Phone:817-504-5507
Mailing Address - Fax:
Practice Address - Street 1:6509 COUNTRY OAKS DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-6111
Practice Address - Country:US
Practice Address - Phone:817-504-5507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist