| Aegis Psychological Consulting Llc | |
|
208 E. Rusk St. Jacksonville TX 75766 | |
| (903) 262-6175 | |
| (903) 534-9311 |
| Full Name | Aegis Psychological Consulting Llc |
|---|---|
| Speciality | Psychologist |
| Location | 208 E. Rusk St., Jacksonville, Texas |
| Authorized Official Name and Position | Nikolaos Kombos (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9032626175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aegis Psychological Consulting Llc P.o. Box 2621 Jacksonville TX 75766 Ph: (903) 262-6175 | Aegis Psychological Consulting Llc 208 E. Rusk St. Jacksonville TX 75766 Ph: (903) 262-6175 |
| NPI Number | 1164703047 |
|---|---|
| Provider Enumeration Date | 09/06/2011 |
| Last Update Date | 05/01/2012 |
| Medicare PECOS PAC ID | 6204098353 |
|---|---|
| Medicare Enrollment ID | O20120507000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164703047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 23624 (Texas) | Primary |
| Provider Name | Nikolaos Kombos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194757930 PECOS PAC ID: 6002084027 Enrollment ID: I20110719000245 |
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