Individual
CHARLES S. CLEELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
2-6856
TX
103T00000X
Psychologist
2-6856
TX
103TC0700X
Clinical Psychologist
Primary
2-6856
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P082128P3
—
TX
Enumeration date
01/29/2007
Last updated
03/25/2014
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