Russell, Roger A

Russell, Roger A is an sole proprietor health care provider with primary practice located at 1049 N 3Rd St Ste 505, Abilene TX 79601-5833. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Russell, Roger A can be contacted via phone (325) 672-8883.

Contact Information

Primary practice address
1049 N 3Rd St Ste 505 Abilene TX 79601-5833
Phone: (325) 672-8883
Fax: (325) 675-5833
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2-2996 Texas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 873LMFT Texas

Profile Details

NPI number 1396746947
LBN Legal business name Russell, Roger A
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2005
Last updated Jan 19th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396746947 NPPES
Texas MEDICAID 0971830-01

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