Neuropsychological Services Of Texarkana Pllc | |
5411 Plaza Dr Ste E Texarkana TX 75503-1667 | |
(903) 255-0171 | |
(903) 255-0172 |
Full Name | Neuropsychological Services Of Texarkana Pllc |
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Speciality | Clinical Neuropsychologist |
Location | 5411 Plaza Dr Ste E, Texarkana, Texas |
Authorized Official Name and Position | Bryan Smith (OWNER) |
Authorized Official Contact | 9032550171 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neuropsychological Services Of Texarkana Pllc 5411 Plaza Dr Ste E Texarkana TX 75503-1667 Ph: (903) 255-0171 | Neuropsychological Services Of Texarkana Pllc 5411 Plaza Dr Ste E Texarkana TX 75503-1667 Ph: (903) 255-0171 |
NPI Number | 1104392067 |
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Provider Enumeration Date | 10/18/2018 |
Last Update Date | 10/18/2018 |
Medicare PECOS PAC ID | 8820332158 |
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Medicare Enrollment ID | O20181127002888 |
Identifier | Type | State | Issuer |
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1104392067 | NPI | - | NPPES |
1306834015 | Other | NEUROPSYCHOLOGIST |
Taxonomy | Type | License (State) | Status |
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103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
Provider Name | Bryan E Smith |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1306834015 PECOS PAC ID: 6709855018 Enrollment ID: I20041018000244 |
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