Individual
DR. RUSSELL THOMAS CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-8693
(210) 916-6679
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-8693
(210) 916-6679
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103T00000X
Psychologist
—
—
Other
Enumeration date
07/06/2007
Last updated
05/11/2020
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