| The Institute Of Neuropsychological Healthcare, Pllc | |
|
9500 Ray White Rd Ste 200 Fort Worth TX 76244-9105 | |
| (817) 745-4567 | |
| (833) 694-0829 |
| Full Name | The Institute Of Neuropsychological Healthcare, Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 9500 Ray White Rd Ste 200, Fort Worth, Texas |
| Authorized Official Name and Position | Emmanuel Rosario Nieves (CLINICAL NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 6822594255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Institute Of Neuropsychological Healthcare, Pllc 9500 Ray White Rd Ste 200 Fort Worth TX 76244-9105 Ph: (787) 407-4268 | The Institute Of Neuropsychological Healthcare, Pllc 9500 Ray White Rd Ste 200 Fort Worth TX 76244-9105 Ph: (817) 745-4567 |
| NPI Number | 1891308730 |
|---|---|
| Provider Enumeration Date | 08/29/2020 |
| Last Update Date | 07/02/2022 |
| Certification Date | 09/02/2020 |
| Medicare PECOS PAC ID | 6800209255 |
|---|---|
| Medicare Enrollment ID | O20210105000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891308730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Emmanuel Mascorro-pinto |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083152656 PECOS PAC ID: 4284972886 Enrollment ID: I20190206001013 |
| Provider Name | Emmanuel Rosario Nieves |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588121560 PECOS PAC ID: 7719227222 Enrollment ID: I20190320001510 |
| Provider Name | Nydia Yaritza Camacho Ortiz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265602445 PECOS PAC ID: 5395077051 Enrollment ID: I20191029003401 |
| Provider Name | Mercy Ngeusang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891310009 PECOS PAC ID: 9335541069 Enrollment ID: I20220922000809 |
| Provider Name | Albabeth Sarraga Rios |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033720305 PECOS PAC ID: 5890163331 Enrollment ID: I20221115001023 |
| Provider Name | Natalie Marie Rios |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295218535 PECOS PAC ID: 5496297558 Enrollment ID: I20240605001221 |
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