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Contact Information

WOODY C CHILDRESS, PhD
5658 WESTCREEK DR STE 400
FORT WORTH, TX76133-2254
 Phone: 817-731-2468
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type
 

Psychologist

103T00000X 62 Psychologist, Clinical
 

School

103TS0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for WOODY C CHILDRESS · (Male)

NPI Number 1013064534
Status Active
Credentials PhD
Entity Individual
Enumeration date 01/05/2007
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # 2-3301
  • TX License # 6637
  • TX Medicaid P000D92R2
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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