Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2-4306 | TX |
NPI | 1134168198 |
---|---|
Provider Name | Andrew Robert Block |
First Address | Plano, TX 75026-2409 |
Second Address | Plano, TX 75093-8171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 20/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00U10P | (02) | TX |
0362725-02 | (05) | TX |