Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 22297 | TX |
Y | 103TC0700X | Clinical Psychologist | 22297 | TX |
NPI | 1003860958 |
---|---|
Provider Name | Carrell Morgan Chadwell |
First Address | Houston, TX 77079-1229 |
Second Address | Houston, TX 77079-1229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
88051H | BCBS (01) | TX |
88198H | BCBS (01) | TX |
R57949 | (02) | TX |