Organization
DOUG CHISHOLM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG CHISHOLM LPC-S (OWNER)
(972) 834-0770
Entity
Organization
Contact information
Practice address
8350 MEADOW RD, STE 198, DALLAS, TX 75231-3768
(972) 834-0770
Mailing address
8350 MEADOW RD, STE 198, DALLAS, TX 75231-3768
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
65003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851643589
NPI NUMBER I ALREADY HAD BEFORE I SWITCHED TO AN S CORPORATION
TX
Enumeration date
09/04/2015
Last updated
09/04/2015
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