| 7872 Inc. | |
|
615 Clinic Dr Longview TX 75605-5172 | |
| (903) 212-3105 | |
| Not Available |
| Full Name | 7872 Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 615 Clinic Dr, Longview, Texas |
| Authorized Official Name and Position | Rupa Peddireddy (PRESIDENT) |
| Authorized Official Contact | 2143925974 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 7872 Inc. 2400 Sugar Creek Cir Longview TX 75605-2580 Ph: (214) 334-6831 | 7872 Inc. 615 Clinic Dr Longview TX 75605-5172 Ph: (903) 212-3105 |
| NPI Number | 1043576218 |
|---|---|
| Provider Enumeration Date | 04/02/2012 |
| Last Update Date | 09/16/2022 |
| Certification Date | 09/16/2022 |
| Medicare PECOS PAC ID | 8325209166 |
|---|---|
| Medicare Enrollment ID | O20120423000162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043576218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Rupa Peddireddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952515827 PECOS PAC ID: 2365598257 Enrollment ID: I20110927000657 |
Kimberly Clough Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 Tristan Ln, Longview, TX 75604 Phone: 903-918-6574 Fax: 903-704-0980 | |
Heather R. Mcconnell, M.a., Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 W Loop 281, Suite 423, Longview, TX 75604 Phone: 903-759-2402 Fax: 903-759-2570 | |
Jonathan C. Lockhart, Md Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 W Loop 281, Suite 111, Longview, TX 75604 Phone: 903-295-8994 Fax: 903-295-8987 | |
Core Health Systems Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1300 N 6th St # A, Longview, TX 75601 Phone: 903-232-8928 Fax: 903-918-1813 | |
Willem H. Fahrenbruck, Lpc, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3122 Nealy Way Ste 201, Longview, TX 75605 Phone: 903-452-8040 | |
Diversified Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1508 W Fairmont St, Suite C, Longview, TX 75604 Phone: 903-238-9553 Fax: 903-291-8709 |