| North Texas State Hospital /wichita Falls | |
|
6515 Kemp Blvd Wichita Falls TX 76308-5419 | |
| (940) 689-1220 | |
| (940) 689-5784 |
| Full Name | North Texas State Hospital /wichita Falls |
|---|---|
| Speciality | Psychologist |
| Location | 6515 Kemp Blvd, Wichita Falls, Texas |
| Authorized Official Name and Position | Jana Johnson (ACCOUNTANT III) |
| Authorized Official Contact | 5122065284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Texas State Hospital /wichita Falls 4110 Guadalupe St Austin TX 78751-4223 Ph: (512) 206-5011 | North Texas State Hospital /wichita Falls 6515 Kemp Blvd Wichita Falls TX 76308-5419 Ph: (940) 689-1220 |
| NPI Number | 1437263738 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 08/25/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437263738 | NPI | - | NPPES |
| 0638249-01 | Medicaid | TX | |
| 1372468-03 | Medicaid | TX | |
| 0827958-01 | Medicaid | TX | |
| 4538344 | Other | TX | PHARMACY NCPDP NUMBER |
| 1372468-02 | Medicaid | TX | |
| 1372468-04 | Medicaid | TX | |
| HH3005 | Other | TX | BCBS DRUG/ALCOHOL |
| HH4614 | Other | TX | BCBS PSYCHIATRIC |
| 0211955-01 | Medicaid | TX |
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