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149 Hart St Sheppard Afb TX 76311-3477 | |
(940) 676-6075 | |
(940) 676-6076 |
Full Name | |
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Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 149 Hart St, Sheppard Afb, Texas |
Authorized Official Name and Position | Christoper James Revis (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 9406764945 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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149 Hart St Sheppard Afb TX 76311-3477 Ph: (940) 676-6075 | 149 Hart St Sheppard Afb TX 76311-3477 Ph: (940) 676-6075 |
NPI Number | 1073593570 |
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Provider Enumeration Date | 01/19/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1073593570 | NPI | - | NPPES |