Ms Nicole R Mabry, PHD is a medicare enrolled "Psychologist - Clinical" provider in San Antonio, Texas. Her current practice location is
7272 Wurzbach Rd, Suite 601, San Antonio, Texas. You can reach out to her office (for appointments etc.) via phone at
(210) 615-3483.
Ms Nicole R Mabry is licensed to practice in Texas (license number 36997) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1144577958.
Healthcare Provider's Profile
| Full Name | Ms Nicole R Mabry |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 7272 Wurzbach Rd, San Antonio, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1144577958
- Provider Enumeration Date: 08/10/2012
- Last Update Date: 12/10/2015
Medicare PECOS Information:
- PECOS PAC ID: 3072830314
- Enrollment ID: I20150325000262
Medical Identifiers
Medical identifiers for Ms Nicole R Mabry such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144577958 | NPI | - | NPPES |
| 36997 | Other | TX | PHD |
| 65777 | Other | TX | LPC LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 65777 (Texas) | Secondary |
| 103TC0700X | Psychologist - Clinical | 36997 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Nicole R Mabry allows following entities to bill medicare on her behalf.
| Entity Name | Deer Oaks Geriatric Services P C |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134169287
PECOS PAC ID: 9234034075
Enrollment ID: O20031204000440 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Nicole R Mabry is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Nicole R Mabry, PHD
7272 Wurzbach Rd, Suite 601,
San Antonio, TX 78240-4801
Ph: (210) 615-3483 | Ms Nicole R Mabry, PHD
7272 Wurzbach Rd, Suite 601,
San Antonio, TX 78240-4801
Ph: (210) 615-3483 |
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