| Matresa Wooding Lcsw Pllc | |
|
7980 Anchor Dr Ste 100a Port Arthur TX 77642-8267 | |
| (409) 727-0014 | |
| (409) 727-0024 |
| Full Name | Matresa Wooding Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 7980 Anchor Dr Ste 100a, Port Arthur, Texas |
| Authorized Official Name and Position | Matresa Wooding (SOLE MBR) |
| Authorized Official Contact | 4097270014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matresa Wooding Lcsw Pllc 7980 Anchor Dr Ste 100a Port Arthur TX 77642-8267 Ph: (409) 727-0014 | Matresa Wooding Lcsw Pllc 7980 Anchor Dr Ste 100a Port Arthur TX 77642-8267 Ph: (409) 727-0014 |
| NPI Number | 1902237480 |
|---|---|
| Provider Enumeration Date | 12/09/2013 |
| Last Update Date | 02/24/2017 |
| Medicare PECOS PAC ID | 1850522053 |
|---|---|
| Medicare Enrollment ID | O20140402000455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902237480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 14647 (Texas) | Primary |
| Provider Name | Matresa Wooding |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336389584 PECOS PAC ID: 2668659103 Enrollment ID: I20110609000090 |
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