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1560 Live Oak St Suite B Webster TX 77598-4147 | |
| (281) 554-6100 | |
| (281) 554-6133 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 1560 Live Oak St, Webster, Texas |
| Authorized Official Name and Position | Michael Jones (OWNER) |
| Authorized Official Contact | 2815546100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1560 Live Oak St Suite B Webster TX 77598-4147 Ph: (281) 554-6100 | 1560 Live Oak St Suite B Webster TX 77598-4147 Ph: (281) 554-6100 |
| NPI Number | 1871501932 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 06/17/2008 |
| Medicare PECOS PAC ID | 5799783239 |
|---|---|
| Medicare Enrollment ID | O20061117000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871501932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 23621 (Texas) | Primary |
| Provider Name | Lesli M Zinn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881602944 PECOS PAC ID: 2264665058 Enrollment ID: I20140501001032 |
| Provider Name | Michael Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205844339 PECOS PAC ID: 3779581210 Enrollment ID: I20140502001477 |
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