| Sandra Harper Pllc | |
|
1820 Shiloh Rd Ste 1503 Tyler TX 75703-2459 | |
| (903) 596-8118 | |
| (903) 856-8125 |
| Full Name | Sandra Harper Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1820 Shiloh Rd Ste 1503, Tyler, Texas |
| Authorized Official Name and Position | Sandra L Harper (PRESIDENT) |
| Authorized Official Contact | 9035968118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra Harper Pllc 17732 Regal Row Flint TX 75762-5712 Ph: () - | Sandra Harper Pllc 1820 Shiloh Rd Ste 1503 Tyler TX 75703-2459 Ph: (903) 596-8118 |
| NPI Number | 1578044384 |
|---|---|
| Provider Enumeration Date | 08/29/2018 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Medicare PECOS PAC ID | 5991058240 |
|---|---|
| Medicare Enrollment ID | O20181102001086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578044384 | NPI | - | NPPES |
| 24006 | Other | TX | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 24006 (Texas) | Primary |
| Provider Name | Sandra Harper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033127279 PECOS PAC ID: 3577736263 Enrollment ID: I20140116000215 |
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