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10450 Brian Mooney Ave El Paso TX 79935 | |
| (915) 598-6616 | |
| (915) 598-6651 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 10450 Brian Mooney Ave, El Paso, Texas |
| Authorized Official Name and Position | Dwayne D Marrott (PSYCHOLOGIST/ PRESIDENT) |
| Authorized Official Contact | 9155986616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 370838 El Paso TX 79937 Ph: (915) 598-6616 | 10450 Brian Mooney Ave El Paso TX 79935 Ph: (915) 598-6616 |
| NPI Number | 1073714838 |
|---|---|
| Provider Enumeration Date | 05/30/2007 |
| Last Update Date | 05/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073714838 | NPI | - | NPPES |
| 034403801 | Medicaid | TX | |
| 8F22682 | Other | TX | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 24316 (Texas) | Primary |
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