Bodden, Jack L.

Bodden, Jack L. is an individual health care provider with primary practice located at 1600 University Dr E , College Station TX 77840-2642. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bodden, Jack L. can be contacted via phone (409) 691-3300.

Contact Information

Primary practice address
1600 University Dr E College Station TX 77840-2642
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20473 Texas

Profile Details

NPI number 1649230814
LBN Legal business name Bodden, Jack L.
Credentials P.H.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jul 10th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1649230814 NPPES
Texas Other 81078P BLUE SHIELD

Popular Providers