Organization Name: | SOUTH TEXAS NEUROBEHAVIORAL GROUP LLC |
NPI Number: | 1568738763 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DOUGLAS B. COOPER (PRESIDENT) |
Mailing Address: | 3603 Paesanos Pkwy Suite 300 San Antonio |
State: | TX US |
Postal Code: | 782311267 |
Phone Number: | 2106143011 |
Fax Number: | 2106156906 |
NPI Enumeration Date: | 04/02/2012 |
NPI Last Update Date: | 04/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 32263 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |