Provider Demographics
NPI:1144321068
Name:HSI, MARLENE P C (PHD)
Entity type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:P C
Last Name:HSI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 UNIVERSITY DR E
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-5902
Mailing Address - Country:US
Mailing Address - Phone:979-268-8199
Mailing Address - Fax:979-260-1450
Practice Address - Street 1:511 UNIVERSITY DR E
Practice Address - Street 2:SUITE 210
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-5902
Practice Address - Country:US
Practice Address - Phone:979-268-8199
Practice Address - Fax:979-260-1450
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-3075103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00H33RMedicare ID - Type Unspecified
TXR58175Medicare UPIN