Individual
DR. RUSSELL A DUNCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3500 OAK LAWN AVE, SUITE 275, DALLAS, TX 75219-4308
(214) 522-0351
(214) 522-0593
Mailing address
3500 OAK LAWN AVE, SUITE 275, DALLAS, TX 75219-4308
(214) 522-0351
(214) 522-0593
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
21515
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00D66R
BC/BS TX
TX
01
—
75-2365650
PHCS
TX
Enumeration date
08/07/2006
Last updated
06/08/2011
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