Provider Demographics
NPI:1447706114
Name:REUTER, TYSON (PHD)
Entity type:Individual
Prefix:DR
First Name:TYSON
Middle Name:
Last Name:REUTER
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 1:7660 WOODWAY DR
Mailing Address - Street 2:SUITE 599
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1533
Mailing Address - Country:US
Mailing Address - Phone:713-914-9944
Mailing Address - Fax:
Practice Address - Street 1:7660 WOODWAY DR
Practice Address - Street 2:SUITE 599
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1533
Practice Address - Country:US
Practice Address - Phone:713-914-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36663103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent