Alexandr Vattamala Philip | |
2301 Olympia Dr Ste 100 Flower Mound TX 75028-1855 | |
(214) 436-2272 | |
(469) 464-9924 |
Full Name | Alexandr Vattamala Philip |
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Speciality | Counselor - Mental Health |
Location | 2301 Olympia Dr Ste 100, Flower Mound, Texas |
Authorized Official Name and Position | Alexandr Vattamala Philip (LICENSED PROFESSIONAL COUNSELOR) |
Authorized Official Contact | 2144362272 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Alexandr Vattamala Philip 1400 Valley Ridge Blvd Apt 5107 Lewisville TX 75077-2998 Ph: (214) 436-2272 | Alexandr Vattamala Philip 2301 Olympia Dr Ste 100 Flower Mound TX 75028-1855 Ph: (214) 436-2272 |
NPI Number | 1104328723 |
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Provider Enumeration Date | 02/28/2018 |
Last Update Date | 02/28/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104328723 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 74513 (Texas) | Primary |
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