| Pennissi P. Taylor Ph.d,pc | |
|
205 Center Ave. Brownwood TX 76801-2919 | |
| (325) 649-4357 | |
| (325) 646-0919 |
| Full Name | Pennissi P. Taylor Ph.d,pc |
|---|---|
| Speciality | Psychologist |
| Location | 205 Center Ave., Brownwood, Texas |
| Authorized Official Name and Position | Pennissi Patrick Taylor (OWNER) |
| Authorized Official Contact | 3256494357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennissi P. Taylor Ph.d,pc Po Box 1391 Brownwood TX 76804-1391 Ph: (325) 649-4357 | Pennissi P. Taylor Ph.d,pc 205 Center Ave. Brownwood TX 76801-2919 Ph: (325) 649-4357 |
| NPI Number | 1114073830 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 12/12/2024 |
| Certification Date | 12/12/2024 |
| Medicare PECOS PAC ID | 9830094192 |
|---|---|
| Medicare Enrollment ID | O20031201000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114073830 | NPI | - | NPPES |
| 0007QC | Other | TX | BCBS |
| 203875 | Other | TX | VALUE OPTIONS INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 15762 (Texas) | Primary |
| Provider Name | Pennissi P Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194850370 PECOS PAC ID: 5193620367 Enrollment ID: I20040907001343 |
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