| Magellan Provider Services, P.a. | |
|
6303 Cowboys Way Ste 350 Frisco TX 75034-0335 | |
| (866) 605-0634 | |
| Not Available |
| Full Name | Magellan Provider Services, P.a. |
|---|---|
| Speciality | Social Worker |
| Location | 6303 Cowboys Way Ste 350, Frisco, Texas |
| Authorized Official Name and Position | Rao Haris Naseem (PRESIDENT) |
| Authorized Official Contact | 9405650800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magellan Provider Services, P.a. 8621 Robert Fulton Dr Columbia MD 21046-2620 Ph: () - | Magellan Provider Services, P.a. 6303 Cowboys Way Ste 350 Frisco TX 75034-0335 Ph: (866) 605-0634 |
| NPI Number | 1255099545 |
|---|---|
| Provider Enumeration Date | 12/03/2021 |
| Last Update Date | 12/03/2021 |
| Certification Date | 12/03/2021 |
| Medicare PECOS PAC ID | 8325433766 |
|---|---|
| Medicare Enrollment ID | O20221004000674 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255099545 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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