Active NPI
William Allen Wandell, PHD
- Clinical Psychologist
- Houston, TX
National Provider Identifier
1245339753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 200218
- Practice address
- 2439 Sunset Blvd
Houston, TX 77005-1431 - Phone
- (713) 729-0472
- Fax
- (713) 729-9927
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 200218 | TX | Primary |
Addresses
Primary practice location
2439 Sunset Blvd
Houston, TX 77005-1431
Mailing address
5418 Queensloch Dr
Houston, TX 77086-4028
Phone (713) 729-0472
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00RD95 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20221 | TX | MD | Mental Health Counselor |
| 200218 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245339753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5418 QUEENSLOCH DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770864028",
"telephone_number": "713-729-0472",
"fax_number": "713-729-9927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2439 SUNSET BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770051431",
"telephone_number": "713-729-0472",
"fax_number": "713-729-9927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANDELL",
"first_name": "WILLIAM",
"middle_name": "ALLEN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "200218",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00RD95",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.