Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 22998 | TX |
N | 103TC0700X | Clinical Psychologist | 22998 | TX |
N | 102L00000X | Psychologist | 22998 | TX |
N | 103T00000X | Psychologist | 22998 | TX |
N | 103TA0700X | Adult Development & Aging Psychologist | 22998 | TX |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 22998 | TX |
N | 103G00000X | Clinical Psychologist | 22998 | TX |
N | 103TC0700X | Clinical Psychologist | 22998 | TX |
N | 103TC1900X | Counseling Psychologist | 22998 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 22998 | TX |
N | 103TF0000X | Family Psychologist | 22998 | TX |
N | 103TF0200X | Forensic Psychologist | 22998 | TX |
N | 103TH0100X | Health Service | 22998 | TX |
N | 103TM1800X | Intellectual & Developmental Disabilities | 22998 | TX |
N | 103TP2701X | Group Psychotherapist | 22998 | TX |
N | 103TR0400X | Rehabilitation Psychologist | 22998 | TX |
NPI | 1003967993 |
---|---|
Provider Name | Dr. Gordon Chenoweth Sauer JR. |
First Address | Irving, TX 75062-4453 |
Second Address | Irving, TX 75062-4453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A52L | BCBS (01) | TX |