| Psp Professional Services, Inc. | |
|
111 Nw 24th St Fort Worth TX 76164-8544 | |
| (817) 626-6401 | |
| (817) 626-6400 |
| Full Name | Psp Professional Services, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 111 Nw 24th St, Fort Worth, Texas |
| Authorized Official Name and Position | Gabriela Garcia (PRESIDENT) |
| Authorized Official Contact | 8176266401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psp Professional Services, Inc. Po Box 4540 Fort Worth TX 76164-0540 Ph: (817) 626-6401 | Psp Professional Services, Inc. 111 Nw 24th St Fort Worth TX 76164-8544 Ph: (817) 626-6401 |
| NPI Number | 1922298322 |
|---|---|
| Provider Enumeration Date | 07/31/2007 |
| Last Update Date | 12/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922298322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 19007 (Texas) | Primary |
| 101YP2500X | Counselor - Professional | 59574 (Texas) | Secondary |
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