Wardell, William Wallace

Wardell, William Wallace is an individual health care provider with primary practice located at 4314 Yoakum Blvd , Houston TX 77006-5818. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Wardell, William Wallace can be contacted via phone (713) 850-0049.

Contact Information

Primary practice address
4314 Yoakum Blvd Houston TX 77006-5818
Phone: (713) 850-0049
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X 23489 Texas
Behavioral Health & Social Service Providers / Clinical 103TC0700X 23489 Texas

Profile Details

NPI number 1770505851
LBN Legal business name Wardell, William Wallace
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Oct 21st, 2011 - about 13 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 1770505851 NPPES
Texas MEDICAID 034153901
Texas MEDICAID 034153902
Texas Other P00930109

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