Provider Demographics
NPI:1447885991
Name:MCCORD, CARLY ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:CARLY
Middle Name:ELIZABETH
Last Name:MCCORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8441 RIVERSIDE PKWY
Mailing Address - Street 2:CB 1, SUITE 1100
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77807
Mailing Address - Country:US
Mailing Address - Phone:979-436-0700
Mailing Address - Fax:
Practice Address - Street 1:8441 RIVERSIDE PKWY
Practice Address - Street 2:CB 1, SUITE 1100
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77807
Practice Address - Country:US
Practice Address - Phone:979-436-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist