Dr Marietta Baccus Richard, PHD - Medicare Psychologist in Southlake, TX

Dr Marietta Baccus Richard, PHD is a medicare enrolled "Psychologist - Clinical" provider in Southlake, Texas. She graduated from medical school in 1990 and has 34 years of diverse experience with area of expertise as Clinical Psychologist. Her current practice location is 1725 E Southlake Blvd Ste 102, Southlake, Texas. You can reach out to her office (for appointments etc.) via phone at (682) 477-4400.

Dr Marietta Baccus Richard is licensed to practice in Texas (license number 24396) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1699950782.

Contact Information

Dr Marietta Baccus Richard, PHD
1725 E Southlake Blvd Ste 102,
Southlake, TX 76092-6457
(682) 477-4400
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Marietta Baccus Richard
GenderFemale
SpecialityClinical Psychologist
Experience34 Years
Location1725 E Southlake Blvd Ste 102, Southlake, Texas
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Marietta Baccus Richard graduated from medical school in 1990
  NPI Data:
  • NPI Number: 1699950782
  • Provider Enumeration Date: 01/08/2008
  • Last Update Date: 06/28/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 3971680240
  • Enrollment ID: I20080410000573

Medical Identifiers

Medical identifiers for Dr Marietta Baccus Richard such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1699950782NPI-NPPES
8K4637OtherTXDOCS MCR
8K4700OtherTXDOMHA MCR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 24396 (Texas)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Marietta Baccus Richard allows following entities to bill medicare on her behalf.
Entity NamePremier Psychology Consultants Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942771787
PECOS PAC ID: 1557602935
Enrollment ID: O20190411002718

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. Dr Marietta Baccus Richard 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 AddressPractice Location Address
Dr Marietta Baccus Richard, PHD
1725 E Southlake Blvd Ste 102,
Southlake, TX 76092-6457

Ph: (682) 477-4400
Dr Marietta Baccus Richard, PHD
1725 E Southlake Blvd Ste 102,
Southlake, TX 76092-6457

Ph: (682) 477-4400

Reviews and Comments


Psychologist in Southlake, TX

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Dr. Wyatt R Evans, PHD
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Phone: 940-368-2664    
Dr. Sarah Helen Thomas Randel, PHD PSYCHOLOGIST
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Practice Location: 250 W Southlake Blvd, Suite 208, Southlake, TX 76092
Phone: 817-988-9472    Fax: 817-379-1731
Dr. April Minatrea, PH.D.
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Practice Location: 211 E Southlake Blvd, Suite 115, Southlake, TX 76092
Phone: 817-404-7999    

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