| Park Cities Child And Adolescent Psychology | |
|
4138 Druid Ln Dallas TX 75205-1143 | |
| (214) 606-8141 | |
| Not Available |
| Full Name | Park Cities Child And Adolescent Psychology |
|---|---|
| Speciality | Psychologist |
| Location | 4138 Druid Ln, Dallas, Texas |
| Authorized Official Name and Position | Frederick Collins Hodges (OWNER/SOLE MEMBER) |
| Authorized Official Contact | 2146068141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Cities Child And Adolescent Psychology 4138 Druid Ln Dallas TX 75205-1143 Ph: (214) 606-8141 | Park Cities Child And Adolescent Psychology 4138 Druid Ln Dallas TX 75205-1143 Ph: (214) 606-8141 |
| NPI Number | 1124414115 |
|---|---|
| Provider Enumeration Date | 04/07/2015 |
| Last Update Date | 11/30/2023 |
| Certification Date | 11/30/2023 |
| Medicare PECOS PAC ID | 5597114033 |
|---|---|
| Medicare Enrollment ID | O20231211000045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124414115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Frederick C Hodges |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568866721 PECOS PAC ID: 4688954175 Enrollment ID: I20161129000185 |
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