Jerryd Wallace, LPC | |
162 N. Dallas Ave, Van Alstyne, TX 75495-7549 | |
(469) 667-3515 | |
Not Available |
Full Name | Jerryd Wallace |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 162 N. Dallas Ave, Van Alstyne, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821573387 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 77418 (Texas) | Primary |
Entity Name | Texoma Community Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851309462 PECOS PAC ID: 6608830104 Enrollment ID: O20041115000959 |
Mailing Address | Practice Location Address |
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Jerryd Wallace, LPC Po Box 2020, Van Alstyne, TX 75495-2020 Ph: (469) 667-3515 | Jerryd Wallace, LPC 162 N. Dallas Ave, Van Alstyne, TX 75495-7549 Ph: (469) 667-3515 |
Katherine Bell Thomasy, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 15048 Us Highway 75 Ste 5, Van Alstyne, TX 75495 Phone: 972-441-7374 | |
Lisa O'connor, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 902 Edwards Rd, Van Alstyne, TX 75495 Phone: 214-394-4517 | |
Jill Renae Heilman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 15048 Us Highway 75 Ste 4, Van Alstyne, TX 75495 Phone: 903-815-1671 | |
Craig Turczynski, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1233 Eagle Point Rd, Van Alstyne, TX 75495 Phone: 314-888-5233 Fax: 203-590-8644 | |
Mr. Lester Isaac Bloomenstiel, M.S., L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 7454 Fm 121, Van Alstyne, TX 75495 Phone: 903-482-5128 Fax: 903-482-5128 | |
Leigh Wood, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 746 S. Waco, Van Alstyne, TX 75495 Phone: 903-267-0048 |