Provider Demographics
NPI:1801946348
Name:DAVID S WACHTEL PHD & ASSOCIATES, PC
Entity type:Organization
Organization Name:DAVID S WACHTEL PHD & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SAUL
Authorized Official - Last Name:WACHTEL
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:713-668-9126
Mailing Address - Street 1:5252 WESTCHESTER ST
Mailing Address - Street 2:105
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4141
Mailing Address - Country:US
Mailing Address - Phone:713-668-9126
Mailing Address - Fax:713-668-9127
Practice Address - Street 1:5252 WESTCHESTER ST
Practice Address - Street 2:105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4141
Practice Address - Country:US
Practice Address - Phone:713-668-9126
Practice Address - Fax:713-668-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22274103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBY67OtherBLUE CROSS BLUE SHIELD