Individual
DR. MICHAEL LEE RUSSELL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2525 NORTH LOOP WEST, SUITE 400, HOUSTON, TX 77008
(832) 394-1440
(832) 394-1448
Mailing address
5 OTTER POND PLACE, THE WOODLANDS, TX 77381-4011
(254) 294-5605
(757) 788-2962
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
38306
TX
103G00000X
Clinical Neuropsychologist
PY00002256
WA
103TC0700X
Clinical Psychologist
Primary
38306
TX
103TC0700X
Clinical Psychologist
PY00002256
WA
Other
Enumeration date
02/13/2006
Last updated
09/22/2023
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