Organization
PAUL K. CHAFETZ PHD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI BILLMAN (CLAIMS MANAGER)
(817) 470-6676
Entity
Organization
Contact information
Practice address
8340 MEADOW RD STE 134, DALLAS, TX 75231
(469) 233-5566
Mailing address
PO BOX 92878, SOUTHLAKE, TX 76092-0878
(817) 470-6676
(541) 637-0298
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
22365
TX
103TC0700X
Clinical Psychologist
Primary
22365
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035835001
—
TX
Enumeration date
08/16/2017
Last updated
05/31/2018
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