Provider Demographics
NPI:1871164657
Name:HOWARD, VICTOR ELLIS (PSYCHOLOGY)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ELLIS
Last Name:HOWARD
Suffix:
Gender:M
Credentials:PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7670 GATEWAY BLVD E APT 7
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-1520
Mailing Address - Country:US
Mailing Address - Phone:336-269-2321
Mailing Address - Fax:
Practice Address - Street 1:7670 GATEWAY BLVD E APT 7
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1520
Practice Address - Country:US
Practice Address - Phone:336-269-2321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
NVNC607481D103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty