| Caviar Clinician, Pllc | |
|
539 West Commerce St. #3754 Dallas TX 75208-1953 | |
| (214) 631-9762 | |
| (214) 617-0282 |
| Full Name | Caviar Clinician, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 539 West Commerce St. #3754, Dallas, Texas |
| Authorized Official Name and Position | Angela Kately Eaglin (OWNER) |
| Authorized Official Contact | 3379094552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Caviar Clinician, Pllc 539 West Commerce St. #3754 Dallas TX 75208-1953 Ph: (214) 631-9762 | Caviar Clinician, Pllc 539 West Commerce St. #3754 Dallas TX 75208-1953 Ph: (214) 631-9762 |
| NPI Number | 1588431001 |
|---|---|
| Provider Enumeration Date | 12/05/2023 |
| Last Update Date | 12/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588431001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
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