Individual
DOUGLAS RAY CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
100 N COLLEGE, SUITE 302, WAXAHACHIE, TX 75165-3702
(214) 207-5664
(888) 765-7459
Mailing address
PO BOX 190408, DALLAS, TX 75219-0408
(214) 207-5664
(888) 765-7459
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22513
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098373602
—
TX
01
—
126296
TEXAS NORTHSTAR, VALUE OP
TX
01
—
7365201
BLUELIKK
TX
01
—
751993021
MAGELLAN
TX
01
—
751993921
INTEGRATED MENTAL HEALTH SERVICES
TX
01
—
81960P
BCBSTX
TX
Enumeration date
02/02/2007
Last updated
03/23/2010
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