| Andrea T Vanderpool, Ph.d., Pllc | |
|
2255 Ridge Rd Suite 210 Rockwall TX 75087-5155 | |
| (972) 722-1711 | |
| (972) 722-1711 |
| Full Name | Andrea T Vanderpool, Ph.d., Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 2255 Ridge Rd, Rockwall, Texas |
| Authorized Official Name and Position | Andrea T Vanderpool (DIRECTOR) |
| Authorized Official Contact | 9727221711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrea T Vanderpool, Ph.d., Pllc 2255 Ridge Rd Suite 210 Rockwall TX 75087-5155 Ph: (972) 722-1711 | Andrea T Vanderpool, Ph.d., Pllc 2255 Ridge Rd Suite 210 Rockwall TX 75087-5155 Ph: (972) 722-1711 |
| NPI Number | 1942437272 |
|---|---|
| Provider Enumeration Date | 06/12/2009 |
| Last Update Date | 06/15/2009 |
| Medicare PECOS PAC ID | 1456657683 |
|---|---|
| Medicare Enrollment ID | O20160314001506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942437272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 33850 (Texas) | Primary |
| Provider Name | Andrea Taylor Vanderpool |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174767446 PECOS PAC ID: 4486950607 Enrollment ID: I20160314001389 |
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