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1205 N Sh 123 Ste 305 San Marcos TX 78666-7756 | |
| (512) 787-0118 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1205 N Sh 123 Ste 305, San Marcos, Texas |
| Authorized Official Name and Position | Jordan Hamilton Robertson (PRESIDENT) |
| Authorized Official Contact | 5127870118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1205 N Sh 123 Ste 103 San Marcos TX 78666-7756 Ph: (512) 787-0118 | 1205 N Sh 123 Ste 305 San Marcos TX 78666-7756 Ph: (512) 787-0118 |
| NPI Number | 1770188278 |
|---|---|
| Provider Enumeration Date | 12/02/2020 |
| Last Update Date | 06/17/2024 |
| Certification Date | 06/17/2024 |
| Medicare PECOS PAC ID | 2860934700 |
|---|---|
| Medicare Enrollment ID | O20240607000226 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770188278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Jordan H Hamilton Robertson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1467790659 PECOS PAC ID: 5193268217 Enrollment ID: I20240618001328 |
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