| Psylrw, Inc | |
|
6001 W Waco Dr Ste M Waco TX 76710-6309 | |
| (254) 772-8055 | |
| (254) 772-3019 |
| Full Name | Psylrw, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 6001 W Waco Dr Ste M, Waco, Texas |
| Authorized Official Name and Position | Laura Ruth Wright (PSYCHOLOGIST) |
| Authorized Official Contact | 2547728055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psylrw, Inc 6001 W Waco Dr Ste M Waco TX 76710-6309 Ph: (254) 772-8055 | Psylrw, Inc 6001 W Waco Dr Ste M Waco TX 76710-6309 Ph: (254) 772-8055 |
| NPI Number | 1205161650 |
|---|---|
| Provider Enumeration Date | 10/02/2009 |
| Last Update Date | 10/02/2009 |
| Medicare PECOS PAC ID | 9830235233 |
|---|---|
| Medicare Enrollment ID | O20091014000704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205161650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 25008 (Texas) | Primary |
| Provider Name | Laura R Wright |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295777134 PECOS PAC ID: 2163471665 Enrollment ID: I20050121000133 |
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