Organization
ETPNS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM A MCBRIDE PHD (OWNER)
(903) 939-0799
Entity
Organization
Contact information
Practice address
700 S PALESTINE ST, ATHENS, TX 75751-3325
(903) 675-9570
(903) 675-9577
Mailing address
700 S PALESTINE ST, ATHENS, TX 75751-3325
(903) 675-9570
(903) 675-9577
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
26853
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8K2170
BCBS GROUP
TX
Enumeration date
11/27/2007
Last updated
11/27/2007
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