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Individual

DR. MICHAEL R GHORMLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
3305 81ST ST, STE H, LUBBOCK, TX 79423-2042
(806) 748-6400
(806) 748-6110
Mailing address
1431 WIRT RD # 104, HOUSTON, TX 77055-4916
(806) 748-6400
(806) 748-6110

Taxonomy

Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
31739
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
165423803
TX
01
86988A
BCBS
TX
Enumeration date
07/08/2006
Last updated
06/10/2008
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