Individual
DR. BETTY JEAN GILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(800) 257-8715
(800) 819-1655
Mailing address
5401 HOLLYTREE DR APT 2604, TYLER, TX 75703-3481
(903) 561-8218
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2-2428
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102715302
—
TX
01
—
86010A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/22/2006
Last updated
07/08/2007
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