| |
305 W Woodard St Ste 209 Denison TX 75020-3136 | |
(903) 265-8545 | |
Not Available |
Full Name | |
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Speciality | Social Worker |
Location | 305 W Woodard St Ste 209, Denison, Texas |
Authorized Official Name and Position | Martin Neary (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 5182443737 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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305 W Woodard St Ste 209 Denison TX 75020-3136 Ph: (903) 265-8545 | 305 W Woodard St Ste 209 Denison TX 75020-3136 Ph: (903) 265-8545 |
NPI Number | 1740971837 |
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Provider Enumeration Date | 05/18/2023 |
Last Update Date | 06/06/2024 |
Certification Date | 06/06/2024 |
Medicare PECOS PAC ID | 1355886201 |
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Medicare Enrollment ID | O20240716000058 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740971837 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Laurie A Trotter |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1881935856 PECOS PAC ID: 8729225354 Enrollment ID: I20130518000099 |
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