Gerald Edward Nissley Jr, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Marshall, Texas. His current practice location is
505 E Travis St Ste 105, Marshall, Texas. You can reach out to his office (for appointments etc.) via phone at
(903) 471-0274.
Gerald Edward Nissley Jr is licensed to practice in Texas (license number 34733) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225332711.
Healthcare Provider's Profile
| Full Name | Gerald Edward Nissley Jr |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 505 E Travis St Ste 105, Marshall, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1225332711
- Provider Enumeration Date: 12/27/2010
- Last Update Date: 07/08/2023
Medicare PECOS Information:
- PECOS PAC ID: 0648455360
- Enrollment ID: I20110422000401
Medical Identifiers
Medical identifiers for Gerald Edward Nissley Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1225332711 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 103TC0700X | Psychologist - Clinical | 34733 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gerald Edward Nissley Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Gerald Edward Nissley Jr, PSYD 505 E Travis St Ste 105, Marshall, TX 75670-4280 Ph: (903) 471-0274 | Gerald Edward Nissley Jr, PSYD 505 E Travis St Ste 105, Marshall, TX 75670-4280 Ph: (903) 471-0274 |
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