| The Victorious Mind Pllc | |
|
103 12th Street Ste 201 Pflugerville TX 78660-3814 | |
| (806) 441-9022 | |
| Not Available |
| Full Name | The Victorious Mind Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 103 12th Street, Pflugerville, Texas |
| Authorized Official Name and Position | Rico Mosby (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 8064419022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Victorious Mind Pllc Po Box 685042 Austin TX 78768-5042 Ph: (806) 441-9022 | The Victorious Mind Pllc 103 12th Street Ste 201 Pflugerville TX 78660-3814 Ph: (806) 441-9022 |
| NPI Number | 1639457641 |
|---|---|
| Provider Enumeration Date | 07/25/2011 |
| Last Update Date | 07/25/2011 |
| Medicare PECOS PAC ID | 6507004645 |
|---|---|
| Medicare Enrollment ID | O20130530000486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639457641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 34808 (Texas) | Primary |
| Provider Name | Rico Mosby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467730473 PECOS PAC ID: 6305084443 Enrollment ID: I20130530000590 |
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