Provider Demographics
NPI:1225179989
Name:ELIZABETH SLEDDEN DYBELL, PH.D., P.C.
Entity type:Organization
Organization Name:ELIZABETH SLEDDEN DYBELL, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:SLEDDEN
Authorized Official - Last Name:DYBELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-218-7004
Mailing Address - Street 1:1770 SAINT JAMES PL
Mailing Address - Street 2:SUITE 405
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3471
Mailing Address - Country:US
Mailing Address - Phone:713-218-7004
Mailing Address - Fax:
Practice Address - Street 1:1770 SAINT JAMES PL
Practice Address - Street 2:SUITE 405
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3471
Practice Address - Country:US
Practice Address - Phone:713-218-7004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23530103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty