| Modern Psychologist Network Llc | |
|
16 E Avenue A Ste 212 Temple TX 76501 | |
| (305) 249-1694 | |
| (305) 647-6045 |
| Full Name | Modern Psychologist Network Llc |
|---|---|
| Speciality | Psychologist |
| Location | 16 E Avenue A Ste 212, Temple, Texas |
| Authorized Official Name and Position | Baron Crespo (CLINICAL & FORENSIC PSYCHOLOGIST) |
| Authorized Official Contact | 3052491694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Psychologist Network Llc 463 Westfield Blvd Apt 121 Temple TX 76502-5319 Ph: () - | Modern Psychologist Network Llc 16 E Avenue A Ste 212 Temple TX 76501 Ph: (305) 249-1694 |
| NPI Number | 1437549755 |
|---|---|
| Provider Enumeration Date | 01/24/2015 |
| Last Update Date | 08/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437549755 | NPI | - | NPPES |
| 381189501 | Medicaid | TX | |
| 631971 | Other | TX | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 37853 (Texas) | Primary |
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