CORWIN BOAKE PH.D. NPI 1942349451

NPI Information

NPI: 1942349451
Provider Name: CORWIN BOAKE, PH.D.
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1333 MOURSUND ST
HOUSTON, TX
ZIP 77030
Phone: (713) 799-6990
Get Directions

Corwin Boake, PH.D. is a clinical neuropsychologist in Houston, TX. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Corwin Boake, PH.D. NPI is 1942349451. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1333 MOURSUND ST
HOUSTON, TX
ZIP 77030-405
Phone: (713) 799-6990
Fax: (713) 799-7049

The NPI 1942349451 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 2/5/2007 and was last updated on 3/30/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TC0700X	Psychologist	Clinical	23147	TEXAS	No
2	103TP0016X	Psychologist	Prescribing (Medical)	MP.0661	LOUISIANA	No
3	103G00000X	Clinical Neuropsychologist		23147	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	88038H	MEDICARE UPIN	TEXAS
2	5DQ62	MEDICARE PIN	LOUISIANA
3	00732T	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	GROUP MCR
4	R56349	MEDICARE UPIN	TEXAS
5	1625642	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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