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GREGG D'ANGELO PHD

Clinical Neuropsychologist

Dallas, Texas

Provider NPI: 1598776593

Provider Information:
 GREGG  D'ANGELO PHD
Gender: M
Not Sole Proprietor

Practice Location:
11882 GREENVILLE AVE STE 121  DALLAS, TX 75243 US
Tel: 972-424-9212  Fax: 972-509-1450

Business Mailing Address:
11882 GREENVILLE AVE STE 121  DALLAS, TX 75243 US
Tel: 972-424-9212  Fax: 972-509-1450

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
TX24947

Other Provider Identifiers:

IssuerNumberStateType
TEXAS LICENSE24947TX01
BLUE CROSS ID W/IN GROUP86850ATX01
0310641 02TX05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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