| Clinical Neuropsychology Of Texas, Pllc | |
|
9643 Huebner Rd Ste 103 San Antonio TX 78240-1752 | |
| (800) 291-1644 | |
| (210) 855-3988 |
| Full Name | Clinical Neuropsychology Of Texas, Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 9643 Huebner Rd Ste 103, San Antonio, Texas |
| Authorized Official Name and Position | Justin O'rourke (OWNER / NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 8002911644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Neuropsychology Of Texas, Pllc 9643 Huebner Rd Ste 103 San Antonio TX 78240-1752 Ph: (800) 291-1644 | Clinical Neuropsychology Of Texas, Pllc 9643 Huebner Rd Ste 103 San Antonio TX 78240-1752 Ph: (800) 291-1644 |
| NPI Number | 1902282759 |
|---|---|
| Provider Enumeration Date | 08/04/2015 |
| Last Update Date | 09/08/2020 |
| Certification Date | 09/04/2020 |
| Medicare PECOS PAC ID | 7618271461 |
|---|---|
| Medicare Enrollment ID | O20160215002249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902282759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 36901 (Texas) | Primary |
| 103T00000X | Psychologist | 36901 (Texas) | Secondary |
| Provider Name | Justin J O Rourke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023354321 PECOS PAC ID: 8527362375 Enrollment ID: I20160215002409 |
| Provider Name | Jonathan Highsmith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568824308 PECOS PAC ID: 5799014015 Enrollment ID: I20190912000748 |
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