Individual
DR. M. THERESA QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.H.D.
Contact information
Practice address
1600 UNIVERSITY DR E, COLLEGE STATION, TX 77840-2642
(409) 691-3300
Mailing address
PO BOX 847408, DALLAS, TX 75284-7408
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
30885
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0408585-01
—
TX
01
—
680012708
RR/MEDICARE
TX
01
—
86346A
BLUE SHIELD
TX
Enumeration date
03/31/2006
Last updated
07/11/2007
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