Individual
DR. CHARLES A HASKOVEC JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3704 MATTISON AVE, FORT WORTH, TX 76107-2619
(817) 732-8441
(817) 732-1833
Mailing address
3704 MATTISON AVE, FORT WORTH, TX 76107-2619
(817) 732-8441
(817) 732-1833
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
21069
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0324470902
—
TX
Enumeration date
07/05/2005
Last updated
02/16/2010
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