Organization
TIMOTHY J DAHEIM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY J DAHEIM PHD (OWNER)
(254) 773-0764
Entity
Organization
Contact information
Practice address
2407 S CLEAR CREEK RD, KILLEEN, TX 76549-5721
(254) 773-0764
(254) 935-2258
Mailing address
PO BOX 204, TEMPLE, TX 76503-0204
(254) 773-0764
(254) 935-2258
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
31399
TX
103TC0700X
Clinical Psychologist
Primary
31399
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140806403
—
TX
05
—
347534501
—
TX
Enumeration date
11/12/2013
Last updated
02/14/2017
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