Jbutlermdphd Pllc | |
5931 Crosslake Pkwy Waco TX 76712-6986 | |
(254) 870-4874 | |
Not Available |
Full Name | Jbutlermdphd Pllc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 5931 Crosslake Pkwy, Waco, Texas |
Authorized Official Name and Position | James E Butler (PHYSICIAN) |
Authorized Official Contact | 2148028051 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Jbutlermdphd Pllc 1333 Skiles St Dallas TX 75204-6108 Ph: (214) 802-8051 | Jbutlermdphd Pllc 5931 Crosslake Pkwy Waco TX 76712-6986 Ph: (254) 870-4874 |
NPI Number | 1942831110 |
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Provider Enumeration Date | 01/28/2020 |
Last Update Date | 04/06/2022 |
Certification Date | 04/06/2022 |
Medicare PECOS PAC ID | 4880006691 |
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Medicare Enrollment ID | O20201221001573 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942831110 | NPI | - | NPPES |
1942831110 | Other | TX | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | James E Butler |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1104118918 PECOS PAC ID: 5799067237 Enrollment ID: I20170118002409 |
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