| Kim Praderas Pllc | |
|
3301 Northland Dr Ste 320 Austin TX 78731-4952 | |
| (512) 458-2606 | |
| (512) 828-7042 |
| Full Name | Kim Praderas Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 3301 Northland Dr Ste 320, Austin, Texas |
| Authorized Official Name and Position | Kim Praderas (PSYCHOLOGIST) |
| Authorized Official Contact | 5124582606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Praderas Pllc 3301 Northland Dr Ste 320 Austin TX 78731-4952 Ph: (512) 458-2606 | Kim Praderas Pllc 3301 Northland Dr Ste 320 Austin TX 78731-4952 Ph: (512) 458-2606 |
| NPI Number | 1619503497 |
|---|---|
| Provider Enumeration Date | 03/12/2020 |
| Last Update Date | 03/12/2020 |
| Certification Date | 03/12/2020 |
| Medicare PECOS PAC ID | 9234549080 |
|---|---|
| Medicare Enrollment ID | O20201105001137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619503497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Kim Praderas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215044581 PECOS PAC ID: 3375601669 Enrollment ID: I20081014000775 |
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