| Troy Alonzo Enis Jr.,inc. | |
|
502 Hill St Bastrop TX 78602-3949 | |
| (512) 308-1220 | |
| Not Available |
| Full Name | Troy Alonzo Enis Jr.,inc. |
|---|---|
| Speciality | Counselor |
| Location | 502 Hill St, Bastrop, Texas |
| Authorized Official Name and Position | Troy Alonzo Enis (PRESIDENT) |
| Authorized Official Contact | 5123081220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Troy Alonzo Enis Jr.,inc. 502 Hill St Bastrop TX 78602-3949 Ph: (512) 925-8815 | Troy Alonzo Enis Jr.,inc. 502 Hill St Bastrop TX 78602-3949 Ph: (512) 308-1220 |
| NPI Number | 1598043085 |
|---|---|
| Provider Enumeration Date | 08/01/2011 |
| Last Update Date | 05/29/2024 |
| Certification Date | 05/29/2024 |
| Medicare PECOS PAC ID | 6305284829 |
|---|---|
| Medicare Enrollment ID | O20240403001920 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598043085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 65953 (Texas) | Primary |
| Provider Name | Troy Alonzo Enis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316229818 PECOS PAC ID: 7113365636 Enrollment ID: I20240403002069 |
Kelly Manuel Bastrop Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 N Hasler Blvd Ste 219, Bastrop, TX 78602 Phone: 512-985-7104 | |
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