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Individual

DR. JOHN L. BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
4500 S LANCASTER RD, VANTHCS, DALLAS, TX 75216-7167
(214) 857-0722
Mailing address
4500 S LANCASTER RD, VANTHCS, DALLAS, TX 75216-7167
(214) 857-0722

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22511
TX

Other

Enumeration date
08/14/2006
Last updated
07/08/2007
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