Individual
DR. PETER L STAVINOHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(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
Primary
25476
TX
103TC0700X
Clinical Psychologist
25476
TX
103TC2200X
Clinical Child & Adolescent Psychologist
25476
TX
103TM1800X
Intellectual & Developmental Disabilities Psychologist
25476
TX
103TR0400X
Rehabilitation Psychologist
25476
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039133606
—
TX
01
—
039133607
CSHCN TPI
TX
Enumeration date
12/04/2006
Last updated
08/18/2020
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