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Individual

DR. GARY B. ROCHELLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
2301 OHIO DR, STE. 130, PLANO, TX 75093-3927
(214) 498-9392
(972) 596-0238
Mailing address
2220 COIT RD, STE. 480, PMB 304, PLANO, TX 75075-3797
(214) 498-9392
(972) 596-0238

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
15435
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0090HV
BCBS PROVIDER NUMBER
TX
01
030388921
TRICARE PROVIDER NUMBER
TX
Enumeration date
04/10/2006
Last updated
12/07/2016
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