Pupfish Llc | |
279 Shadow Mountain Dr # 307 El Paso TX 79912-4707 | |
(713) 504-2681 | |
Not Available |
Full Name | Pupfish Llc |
---|---|
Speciality | Counselor - Professional |
Location | 279 Shadow Mountain Dr # 307, El Paso, Texas |
Authorized Official Name and Position | Joseph Carlson (OWNER/LPC) |
Authorized Official Contact | 7135042681 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pupfish Llc 6848 Orizaba Ave El Paso TX 79912-2306 Ph: (713) 504-2681 | Pupfish Llc 279 Shadow Mountain Dr # 307 El Paso TX 79912-4707 Ph: (713) 504-2681 |
NPI Number | 1023587334 |
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Provider Enumeration Date | 11/15/2018 |
Last Update Date | 11/16/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023587334 | NPI | - | NPPES |
PENDING | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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