| Neogen Mental Health And Behavioral Services, Pa. | |
|
2141 Kirkwood Blvd Ste 130 Southlake TX 76092-1464 | |
| (469) 955-5223 | |
| (817) 251-8844 |
| Full Name | Neogen Mental Health And Behavioral Services, Pa. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2141 Kirkwood Blvd Ste 130, Southlake, Texas |
| Authorized Official Name and Position | Eugene H Fletcher (PSYCHIATRIST) |
| Authorized Official Contact | 4699555223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neogen Mental Health And Behavioral Services, Pa. 2141 Kirkwood Blvd Ste 130 Southlake TX 76092-1464 Ph: (469) 955-5223 | Neogen Mental Health And Behavioral Services, Pa. 2141 Kirkwood Blvd Ste 130 Southlake TX 76092-1464 Ph: (469) 955-5223 |
| NPI Number | 1104445220 |
|---|---|
| Provider Enumeration Date | 04/09/2020 |
| Last Update Date | 04/09/2020 |
| Certification Date | 04/09/2020 |
| Medicare PECOS PAC ID | 5991238362 |
|---|---|
| Medicare Enrollment ID | O20241024002118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104445220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Eugene Fletcher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548231806 PECOS PAC ID: 3375869282 Enrollment ID: I20150311001043 |
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