| Nicole Bereolos, Phd, Pllc | |
|
9330 Lbj Fwy Ste 900 Dallas TX 75243-3443 | |
| (972) 768-7994 | |
| Not Available |
| Full Name | Nicole Bereolos, Phd, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 9330 Lbj Fwy Ste 900, Dallas, Texas |
| Authorized Official Name and Position | Nicole Bereolos (OWNER) |
| Authorized Official Contact | 9727687994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Bereolos, Phd, Pllc 2033 W Mcdermott Dr, Ste 320 #184 Allen TX 75013-4675 Ph: () - | Nicole Bereolos, Phd, Pllc 9330 Lbj Fwy Ste 900 Dallas TX 75243-3443 Ph: (972) 768-7994 |
| NPI Number | 1184115313 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 05/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184115313 | NPI | - | NPPES |
| 289346301 | Medicaid | TX | |
| 60054 | Other | AETNA | |
| 0012XH | Other | BCBS | |
| 1427341825 | Other | NPI | |
| 3809908 | Other | CIGNA | |
| 600766136 | Other | MAGELLAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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