| The Telos Project | |
|
7801 Oakmont Blvd Ste 101 Fort Worth TX 76132-4242 | |
| (682) 841-1475 | |
| (682) 708-3775 |
| Full Name | The Telos Project |
|---|---|
| Speciality | Psychologist |
| Location | 7801 Oakmont Blvd Ste 101, Fort Worth, Texas |
| Authorized Official Name and Position | Anthony Bean (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6828411475 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Telos Project 7801 Oakmont Blvd Ste 101 Fort Worth TX 76132-4242 Ph: (682) 841-1475 | The Telos Project 7801 Oakmont Blvd Ste 101 Fort Worth TX 76132-4242 Ph: (682) 841-1475 |
| NPI Number | 1457893232 |
|---|---|
| Provider Enumeration Date | 11/10/2016 |
| Last Update Date | 11/01/2023 |
| Certification Date | 11/01/2023 |
| Medicare PECOS PAC ID | 1153603469 |
|---|---|
| Medicare Enrollment ID | O20170123000540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457893232 | NPI | - | NPPES |
| 367589401 | Medicaid | TX |
| Provider Name | Anthony Bean |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831471697 PECOS PAC ID: 7517255060 Enrollment ID: I20161017000261 |
| Provider Name | Carol H Bean |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518392075 PECOS PAC ID: 0941582266 Enrollment ID: I20170126000350 |
| Provider Name | Alexandra L Marks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851820492 PECOS PAC ID: 2567736366 Enrollment ID: I20170918001504 |
| Provider Name | Nerak A Dickerson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790217347 PECOS PAC ID: 7113379363 Enrollment ID: I20240123004137 |
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