| Annette M Clark, LICSW | |
|
2900 E 29th St, Bryan, TX 77802-2622 | |
| (979) 776-8400 | |
| (877) 601-5854 |
| Full Name | Annette M Clark |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 17 Years |
| Location | 2900 E 29th St, Bryan, 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 |
|---|---|---|---|
| 1366828477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 11843 (Minnesota) | Secondary |
| 1041C0700X | Social Worker - Clinical | 112234 (Texas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Texas Aandm University System Health Science Center | 8224008644 | 42 |
| Entity Name | Texas A&m University System Health Science Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063699312 PECOS PAC ID: 8224008644 Enrollment ID: O20040802001578 |
| Mailing Address | Practice Location Address |
|---|---|
| Annette M Clark, LICSW 124 Elton Hills Ln Nw, Rochester, MN 55901-3577 Ph: (507) 282-1009 | Annette M Clark, LICSW 2900 E 29th St, Bryan, TX 77802-2622 Ph: (979) 776-8400 |
Deborah Dyjak Diaz, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2700 E 29th St Ste 325, Bryan, TX 77802 Phone: 979-704-6509 Fax: 979-821-7372 | |
Tal Nesichi, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2900 E 29th St, Bryan, TX 77802 Phone: 979-436-0605 | |
Wendy Mcdonald, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 207 Sulphur Springs Rd, Bryan, TX 77801 Phone: 979-846-8600 Fax: 866-214-0222 | |
Rhonda Rochell Davies, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 971 Marquis Dr, Bryan, TX 77803 Phone: 269-369-5453 | |
Laura Bauer, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2490 Boonville Rd, Bryan, TX 77808 Phone: 979-703-1808 | |
Martha Macpherson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1318 Memorial Dr, Bryan, TX 77802 Phone: 979-776-2872 | |
Heather Camille Naumann, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 2900 E 29th St, Bryan, TX 77802 Phone: 979-436-9164 |