| Statera Clinical And Forensic Services, Pllc | |
|
1002 Taylor St Brownsville TX 78520-7108 | |
| (956) 320-7036 | |
| Not Available |
| Full Name | Statera Clinical And Forensic Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1002 Taylor St, Brownsville, Texas |
| Authorized Official Name and Position | Yasisca Pujols (PHD/PRESIDENT) |
| Authorized Official Contact | 9563207036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Statera Clinical And Forensic Services, Pllc 1002 Taylor St Brownsville TX 78520-7108 Ph: (956) 320-7036 | Statera Clinical And Forensic Services, Pllc 1002 Taylor St Brownsville TX 78520-7108 Ph: (956) 320-7036 |
| NPI Number | 1578186136 |
|---|---|
| Provider Enumeration Date | 05/18/2020 |
| Last Update Date | 06/03/2020 |
| Certification Date | 06/03/2020 |
| Medicare PECOS PAC ID | 9537580899 |
|---|---|
| Medicare Enrollment ID | O20200522001762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578186136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Yasisca Pujols |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871936500 PECOS PAC ID: 0446671705 Enrollment ID: I20200522001880 |
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