Provider Demographics
NPI:1720691348
Name:KAHN, DAVID ANDREW (PHD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:KAHN
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 1:229 INDIAN PAINT BRUSH
Mailing Address - Street 2:
Mailing Address - City:EDDY
Mailing Address - State:TX
Mailing Address - Zip Code:76524-2624
Mailing Address - Country:US
Mailing Address - Phone:254-215-2454
Mailing Address - Fax:254-215-2451
Practice Address - Street 1:400 N WALL ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-3143
Practice Address - Country:US
Practice Address - Phone:254-654-1515
Practice Address - Fax:254-215-2451
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33559103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist