Mary Travis, LCSW | |
400 Airport Rd, Terrell, TX 75160-4302 | |
(972) 524-4159 | |
(972) 563-4433 |
Full Name | Mary Travis |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 400 Airport Rd, Terrell, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932522729 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 52564 (Texas) | Primary |
Entity Name | Assurasource Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194746016 PECOS PAC ID: 8123125580 Enrollment ID: O20070518000258 |
Mailing Address | Practice Location Address |
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Mary Travis, LCSW Po Box 747, Terrell, TX 75160-0014 Ph: (972) 524-4159 | Mary Travis, LCSW 400 Airport Rd, Terrell, TX 75160-4302 Ph: (972) 524-4159 |
Mr. Leonard Clarence De Grate Jr., MSSW-LCSW-ACSW-DCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1136 Robin Rd, Terrell, TX 75161 Phone: 972-551-8521 | |
Patrice Douglisa Harrison, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1033 Secretariat Dr, Terrell, TX 75160 Phone: 972-552-3735 Fax: 972-552-3735 | |
Mrs. Bonnie Celeste Dockery, LCSW, LMFT Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 102 E Moore Ave, Suite 225, Terrell, TX 75160 Phone: 800-697-4296 Fax: 972-551-2927 | |
Rallayne Deniece Erwin, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 600 1st St, Terrell, TX 75160 Phone: 214-934-9553 |