Provider Demographics
NPI:1316435134
Name:NEWMAN, GUNNAR G (PHD)
Entity type:Individual
Prefix:
First Name:GUNNAR
Middle Name:G
Last Name:NEWMAN
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 KELL BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-1060
Mailing Address - Country:US
Mailing Address - Phone:940-340-5194
Mailing Address - Fax:940-301-3938
Practice Address - Street 1:2525 KELL BLVD STE 405
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-1060
Practice Address - Country:US
Practice Address - Phone:940-340-5194
Practice Address - Fax:940-301-3938
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75036101YP2500X
TX39832103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional