| Shore & Associates Pc | |
|
804 Spring Creek Dr Tyler TX 75703 | |
| (903) 939-8760 | |
| (903) 939-8760 |
| Full Name | Shore & Associates Pc |
|---|---|
| Speciality | Psychologist |
| Location | 804 Spring Creek Dr, Tyler, Texas |
| Authorized Official Name and Position | Robert J Shore (PRESIDENT) |
| Authorized Official Contact | 9039398760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore & Associates Pc 804 Spring Creek Dr Tyler TX 75703 Ph: (903) 939-8760 | Shore & Associates Pc 804 Spring Creek Dr Tyler TX 75703 Ph: (903) 939-8760 |
| NPI Number | 1093982258 |
|---|---|
| Provider Enumeration Date | 05/15/2008 |
| Last Update Date | 05/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093982258 | NPI | - | NPPES |
| 040822101 | Medicaid | TX | |
| 11601-160-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 24292 (Tennessee) | Primary |
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