Dr Mary Ann Thamaravelil Gansle, PHD is a
Psychologist based in Portland, Texas. Dr Mary Ann Thamaravelil Gansle is licensed to practice in Texas (license number 35139) and her current practice location is
1700 Wildcat Dr, Suite D, Portland, Texas. She can be reached at her office (for appointments etc.) via phone at
(361) 445-4080.
NPI number for Dr Mary Ann Thamaravelil Gansle is 1386921674 and her current mailing address is 1019 Forest Oak, Portland, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1386921674.
Healthcare Provider's Profile
| Full Name | Dr Mary Ann Thamaravelil Gansle |
|---|
| Gender | Female |
|---|
| Speciality | Psychologist |
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| Location | 1700 Wildcat Dr, Portland, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1386921674
- Provider Enumeration Date: 11/15/2011
- Last Update Date: 11/17/2011
Medical Identifiers
Medical identifiers for Dr Mary Ann Thamaravelil Gansle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386921674 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 35139 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mary Ann Thamaravelil Gansle is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mary Ann Thamaravelil Gansle, PHD
1019 Forest Oak,
Portland, TX 78374-4153
Ph: (361) 425-2692 | Dr Mary Ann Thamaravelil Gansle, PHD
1700 Wildcat Dr, Suite D,
Portland, TX 78374-2817
Ph: (361) 445-4080 |
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