| G. Gary Walker, Ph.d., P.c. | |
|
5120 29th Dr Ste D Lubbock TX 79407-2612 | |
| (806) 798-8855 | |
| (806) 792-5715 |
| Full Name | G. Gary Walker, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 5120 29th Dr Ste D, Lubbock, Texas |
| Authorized Official Name and Position | George Gary Walker (PRESIDENT OF THE CORPORATION) |
| Authorized Official Contact | 8067988855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| G. Gary Walker, Ph.d., P.c. 5203 28th St Lubbock TX 79407-3507 Ph: (806) 798-8855 | G. Gary Walker, Ph.d., P.c. 5120 29th Dr Ste D Lubbock TX 79407-2612 Ph: (806) 798-8855 |
| NPI Number | 1033234976 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 10/25/2022 |
| Certification Date | 10/25/2022 |
| Medicare PECOS PAC ID | 9830273002 |
|---|---|
| Medicare Enrollment ID | O20080318000640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033234976 | NPI | - | NPPES |
| 192465602 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| Provider Name | George Gary Walker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154465409 PECOS PAC ID: 6709962640 Enrollment ID: I20101014000154 |
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