Maryrita Kaiser Mallet,md Pa | |
116 Santa Fe Dr Weatherford TX 76086-6548 | |
(817) 613-1942 | |
(817) 341-3882 |
Full Name | Maryrita Kaiser Mallet,md Pa |
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Speciality | Psychiatry & Neurology |
Location | 116 Santa Fe Dr, Weatherford, Texas |
Authorized Official Name and Position | Maryrita Kaiser Mallet (PRESIDENT) |
Authorized Official Contact | 8176131942 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Maryrita Kaiser Mallet,md Pa Po Box 1976 Weatherford TX 76086-7976 Ph: (817) 613-1942 | Maryrita Kaiser Mallet,md Pa 116 Santa Fe Dr Weatherford TX 76086-6548 Ph: (817) 613-1942 |
NPI Number | 1962680389 |
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Provider Enumeration Date | 02/07/2008 |
Last Update Date | 04/27/2012 |
Medicare PECOS PAC ID | 1254593676 |
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Medicare Enrollment ID | O20120501000794 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962680389 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | J4322 (Texas) | Primary |
Provider Name | Maryrita K Mallet |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1366478182 PECOS PAC ID: 4880856202 Enrollment ID: I20120502000070 |
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