Provider Demographics
NPI:1780963819
Name:TIMMONS, CURTIS LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:LEE
Last Name:TIMMONS
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 1:6801 SANGER AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7818
Mailing Address - Country:US
Mailing Address - Phone:254-751-9606
Mailing Address - Fax:254-751-9606
Practice Address - Street 1:6801 SANGER AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7818
Practice Address - Country:US
Practice Address - Phone:254-751-9606
Practice Address - Fax:254-751-9606
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-07
Last Update Date:2011-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23006103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist