Provider Demographics
NPI:1356559637
Name:CHOCK, STEPHEN K (PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:K
Last Name:CHOCK
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 1:6821 COLONNADE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6319
Mailing Address - Country:US
Mailing Address - Phone:972-618-7857
Mailing Address - Fax:
Practice Address - Street 1:3505 GASTON AVE
Practice Address - Street 2:NEUROPSYCHOLOGY DEPT.
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2018
Practice Address - Country:US
Practice Address - Phone:214-820-9384
Practice Address - Fax:214-820-9259
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-3764103G00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling