Organization
JAVIER CARRILLO, PHD. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAVIER CARRILLO PHD (OWNER/PROVIDER)
(915) 491-0707
Entity
Organization
Contact information
Practice address
2300 GEORGE DIETER DR, EL PASO, TX 79936-3963
(915) 491-0707
Mailing address
2300 GEORGE DIETER DR, EL PASO, TX 79936-3963
(915) 491-0707
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24690
MEDICAL LICENSE
TX
Enumeration date
08/11/2020
Last updated
09/01/2020
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