Dr Eboni Tiana Butler, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Fresno, Texas. Her current practice location is
4031 Forest Teal Ct, Fresno, Texas. You can reach out to her office (for appointments etc.) via phone at
(281) 431-5323.
Dr Eboni Tiana Butler is licensed to practice in Texas (license number 34589) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1972733723.
Healthcare Provider's Profile
Full Name | Dr Eboni Tiana Butler |
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Gender | Female |
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Speciality | Psychologist - Clinical |
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Location | 4031 Forest Teal Ct, Fresno, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1972733723
- Provider Enumeration Date: 07/15/2009
- Last Update Date: 06/13/2017
Medicare PECOS Information:
- PECOS PAC ID: 7618148479
- Enrollment ID: I20110927000825
Medical Identifiers
Medical identifiers for Dr Eboni Tiana Butler such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1972733723 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 62492 (Texas) | Secondary |
103TC0700X | Psychologist - Clinical | 34589 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Eboni Tiana Butler allows following entities to bill medicare on her behalf.
Entity Name | Butler Psychological Group Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1740549823 PECOS PAC ID: 6002079092 Enrollment ID: O20120601000260 |
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Entity Name | Amazing Healthcare Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1821354358 PECOS PAC ID: 4385867225 Enrollment ID: O20140522001504 |
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Entity Name | Wellspring Family & Community Institute Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1902243256 PECOS PAC ID: 5991948895 Enrollment ID: O20160617001037 |
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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 Eboni Tiana Butler is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Eboni Tiana Butler, PSYD 4031 Forest Teal Ct, Fresno, TX 77545-8648 Ph: (281) 431-5323 | Dr Eboni Tiana Butler, PSYD 4031 Forest Teal Ct, Fresno, TX 77545-8648 Ph: (281) 431-5323 |
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