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Individual

GARY LEE TIPTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
EDD

Contact information

Practice address
25810 OAK RIDGE DR, THE WOODLANDS, TX 77380-2016
(281) 364-0067
(281) 364-0712
Mailing address
14015 LOCHSHIRE ST, HOUSTON, TX 77077-1830
(281) 589-7742

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2-3388
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86745A
BCBS
TX
Enumeration date
07/03/2006
Last updated
03/19/2008
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