Dr Marietta Baccus Richard, PHD | |
1725 E Southlake Blvd Ste 102, Southlake, TX 76092-6457 | |
(682) 477-4400 | |
Not Available |
Full Name | Dr Marietta Baccus Richard |
---|---|
Gender | Female |
Speciality | Clinical Psychologist |
Experience | 34 Years |
Location | 1725 E Southlake Blvd Ste 102, Southlake, Texas |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699950782 | NPI | - | NPPES |
8K4637 | Other | TX | DOCS MCR |
8K4700 | Other | TX | DOMHA MCR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 24396 (Texas) | Primary |
Entity Name | Premier Psychology Consultants Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942771787 PECOS PAC ID: 1557602935 Enrollment ID: O20190411002718 |
Mailing Address | Practice Location Address |
---|---|
Dr Marietta Baccus Richard, PHD 1725 E Southlake Blvd Ste 102, Southlake, TX 76092-6457 Ph: (682) 477-4400 | Dr Marietta Baccus Richard, PHD 1725 E Southlake Blvd Ste 102, Southlake, TX 76092-6457 Ph: (682) 477-4400 |
Dr. Ashley Harrison Noble, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 211 E Southlake Blvd Ste 101, Southlake, TX 76092 Phone: 817-488-3538 | |
Dr. Kate Stark, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1723 E Southlake Blvd Ste 200, Southlake, TX 76092 Phone: 682-292-7012 | |
Ryan Edward Holt, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1723 E Southlake Blvd Ste 200, Southlake, TX 76092 Phone: 682-292-7012 | |
Ms. Avni Vyas, PH.D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 10725 East Southlake Blvd, 102, Southlake, TX 76092 Phone: 817-618-9307 Fax: 817-977-8553 | |
Dr. Wyatt R Evans, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1723 E Southlake Blvd Ste 120, Southlake, TX 76092 Phone: 940-368-2664 | |
Dr. Sarah Helen Thomas Randel, PHD PSYCHOLOGIST Psychologist Medicare: Not Enrolled in Medicare Practice Location: 250 W Southlake Blvd, Suite 208, Southlake, TX 76092 Phone: 817-988-9472 Fax: 817-379-1731 | |
Dr. April Minatrea, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 211 E Southlake Blvd, Suite 115, Southlake, TX 76092 Phone: 817-404-7999 |