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1001 Pat Booker Rd Ste 207 Universal City TX 78148-4148 | |
| (210) 903-0130 | |
| (800) 383-9015 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1001 Pat Booker Rd Ste 207, Universal City, Texas |
| Authorized Official Name and Position | Temora P Gray (OWNER) |
| Authorized Official Contact | 2109030130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9303 Avondale Park Converse TX 78109-0357 Ph: (917) 783-8065 | 1001 Pat Booker Rd Ste 207 Universal City TX 78148-4148 Ph: (210) 903-0130 |
| NPI Number | 1437969987 |
|---|---|
| Provider Enumeration Date | 01/08/2025 |
| Last Update Date | 01/14/2025 |
| Certification Date | 01/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437969987 | NPI | - | NPPES |
| 1437699987 | Other | TX | CLINICAL PSYCHOLOGY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Secondary |
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