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Individual

CHARLES LANDIS GILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
3601 4TH ST, STE. 1A122, LUBBOCK, TX 79430-0002
(806) 743-2800
(806) 743-4250
Mailing address
PO BOX 27476, SALT LAKE CITY, UT 84127-0476
(806) 743-2898
(806) 743-2787

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
25129
TX

Other

Enumeration date
11/28/2012
Last updated
11/18/2019
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