Individual
CHARLES H DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
12012 WICKCHESTER LN, SUITE 550, HOUSTON, TX 77079-1229
(832) 448-2800
(832) 448-2801
Mailing address
12012 WICKCHESTER LN, SUITE 550, HOUSTON, TX 77079-1229
(832) 448-2800
(832) 448-2801
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
25358
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041075502
—
TX
05
—
041075503
—
TX
01
—
680014099
RAILROAD
TX
01
—
83149P
BCBS
TX
01
—
83153P
BCBS
TX
Enumeration date
06/12/2006
Last updated
03/10/2008
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