| Wilson Renfroe, Psyd, Pllc | |
|
4801 Troup Hwy Suite 502 Tyler TX 75703-2356 | |
| (903) 630-7091 | |
| Not Available |
| Full Name | Wilson Renfroe, Psyd, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 4801 Troup Hwy, Tyler, Texas |
| Authorized Official Name and Position | Thomas Wilson Renfroe (OWNER) |
| Authorized Official Contact | 9036307091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson Renfroe, Psyd, Pllc 4801 Troup Hwy Suite 502 Tyler TX 75703-2356 Ph: (903) 630-7091 | Wilson Renfroe, Psyd, Pllc 4801 Troup Hwy Suite 502 Tyler TX 75703-2356 Ph: (903) 630-7091 |
| NPI Number | 1952707556 |
|---|---|
| Provider Enumeration Date | 11/08/2014 |
| Last Update Date | 11/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952707556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 24047 (Texas) | Primary |
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