Provider Demographics
NPI:1902270630
Name:JAY DANIEL DUHON, PH.D., PLLC
Entity Type:Organization
Organization Name:JAY DANIEL DUHON, PH.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUHON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-476-4137
Mailing Address - Street 1:13435 MILL GROVE LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5535
Mailing Address - Country:US
Mailing Address - Phone:214-476-4137
Mailing Address - Fax:972-867-3402
Practice Address - Street 1:2301 OHIO DR
Practice Address - Street 2:STE. 130
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3927
Practice Address - Country:US
Practice Address - Phone:214-476-4137
Practice Address - Fax:972-867-3402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty