Individual
DR. ROBERT SPERRY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3334 SSW LOOP 323, TYLER, TX 75701-9237
(903) 534-5968
Mailing address
PO BOX 2186, FLINT, TX 75762-2186
(903) 534-5968
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
23178
TX
103TC0700X
Clinical Psychologist
Primary
23178
TX
103TC2200X
Clinical Child & Adolescent Psychologist
23178
TX
103TF0200X
Forensic Psychologist
23178
TX
103TM1800X
Intellectual & Developmental Disabilities Psychologist
23178
TX
103TS0200X
School Psychologist
6166
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0082EF
BLUE CROSS BLUE SHIELD
TX
05
—
156900601
—
TX
Enumeration date
01/11/2007
Last updated
05/25/2021
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