Provider Demographics
NPI:1619593514
Name:WARD, ANTHONY R (PHD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:R
Last Name:WARD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 KIRBY DR APT 2114
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4397
Mailing Address - Country:US
Mailing Address - Phone:505-440-1803
Mailing Address - Fax:
Practice Address - Street 1:5858 WESTHEIMER RD STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5643
Practice Address - Country:US
Practice Address - Phone:713-487-9310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38464103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical