Individual
DR. TODD S LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7272 WURZBACH RD, SUITE 1504, SAN ANTONIO, TX 78240-4801
(210) 522-1187
(210) 647-7805
Mailing address
7272 WURZBACH RD, SUITE 1504, SAN ANTONIO, TX 78240-4801
(210) 522-1187
(210) 647-7805
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
23132
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A06L
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
09/20/2006
Last updated
07/08/2007
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