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101 S Trinity St Decatur TX 76234-1819 | |
| (940) 627-1630 | |
| (940) 626-3741 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 101 S Trinity St, Decatur, Texas |
| Authorized Official Name and Position | Carolyn Mccomis (OWNER/COUNSELOR) |
| Authorized Official Contact | 9406271630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
101 S Trinity St Decatur TX 76234-1819 Ph: (940) 627-1630 | 101 S Trinity St Decatur TX 76234-1819 Ph: (940) 627-1630 |
| NPI Number | 1316246630 |
|---|---|
| Provider Enumeration Date | 03/25/2011 |
| Last Update Date | 03/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316246630 | NPI | - | NPPES |
| 175788201 | Medicaid | TX | |
| RENDERING NPI | Other | TX | 1760563514 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 19764 (Texas) | Primary |
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