Individual
ROBERT FORREST WILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
12012 WICKCHESTER LN, SUITE 550, HOUSTON, TX 77079-1229
(832) 448-2800
(832) 448-2801
Mailing address
12012 WICKCHESTER LN, SUITE 550, HOUSTON, TX 77079-1229
(832) 448-2800
(832) 448-2801
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
R56248
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097306704
—
TX
05
—
162395101
—
TX
01
—
86856A
BCBS
TX
Enumeration date
06/14/2006
Last updated
03/15/2011
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