Engedi Life Care, Pllc | |
1464 E Whitestone Blvd Ste 202 Cedar Park TX 78613-9062 | |
(512) 528-5356 | |
Not Available |
Full Name | Engedi Life Care, Pllc |
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Speciality | Community/Behavioral Health |
Location | 1464 E Whitestone Blvd Ste 202, Cedar Park, Texas |
Authorized Official Name and Position | Pamela A. Bermender (MARRIAGE & FAMILY THERAPIST) |
Authorized Official Contact | 5125285356 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Engedi Life Care, Pllc 1464 E Whitestone Blvd Ste 202 Cedar Park TX 78613-9062 Ph: (512) 528-5356 | Engedi Life Care, Pllc 1464 E Whitestone Blvd Ste 202 Cedar Park TX 78613-9062 Ph: (512) 528-5356 |
NPI Number | 1508140971 |
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Provider Enumeration Date | 10/04/2011 |
Last Update Date | 10/23/2012 |
Medicare PECOS PAC ID | 3375986037 |
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Medicare Enrollment ID | O20240209000324 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508140971 | NPI | - | NPPES |
201504 | Other | TX | MFT LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 201504 (Texas) | Primary |
Provider Name | Pamela A Bermender |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1104179233 PECOS PAC ID: 8628411386 Enrollment ID: I20240209000388 |
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