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2025 Memory Ln Ste 500 Harker Heights TX 76548-7489 | |
| (806) 810-0585 | |
| (806) 517-2667 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2025 Memory Ln Ste 500, Harker Heights, Texas |
| Authorized Official Name and Position | Kelly Johnson (DIRECTOR OF CREDENDIALING) |
| Authorized Official Contact | 7853206616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2025 Memory Ln Ste 500 Harker Heights TX 76548-7489 Ph: (806) 810-0585 | 2025 Memory Ln Ste 500 Harker Heights TX 76548-7489 Ph: (806) 810-0585 |
| NPI Number | 1205573425 |
|---|---|
| Provider Enumeration Date | 05/18/2022 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205573425 | NPI | - | NPPES |
| T6078 | Other | TX | LICENSE |
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