Individual
CHARLES H DALTON
Active
Individual
CHARLES H DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
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
Update your record
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