| Mr Paul W Bagwell Jr, PSYD | |
|
3695 Hot Springs Blvd, Las Vegas, NM 87701-9549 | |
| (505) 454-2100 | |
| (505) 454-2130 |
| Full Name | Mr Paul W Bagwell Jr |
|---|---|
| Gender | Male |
| Speciality | Psychologist - Clinical |
| Location | 3695 Hot Springs Blvd, Las Vegas, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477608453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0854 (New Mexico) | Primary |
| Entity Name | State Of New Mexico |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992867998 PECOS PAC ID: 2062412869 Enrollment ID: O20091021000191 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Paul W Bagwell Jr, PSYD 3695 Hot Springs Blvd, Las Vegas, NM 87701-9549 Ph: (505) 454-2100 | Mr Paul W Bagwell Jr, PSYD 3695 Hot Springs Blvd, Las Vegas, NM 87701-9549 Ph: (505) 454-2100 |
Wendy Price, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3695 Hot Springs Blvd, Las Vegas, NM 87701 Phone: 505-454-2100 | |
William Frank Merkle, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3695 Hot Springs Blvd, Las Vegas, NM 87701 Phone: 505-454-2457 | |
Ms. Michelle Ulibarri, PSY Psychologist Medicare: Not Enrolled in Medicare Practice Location: 179 Bridge St, Las Vegas, NM 87701 Phone: 505-426-2554 | |
Dr. Diana Calderon, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1801 Seventh Street, Las Vegas, NM 87701 Phone: 505-454-9758 Fax: 505-454-9755 | |
Rudy Fidencio Grano, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 213 Plaza St, N/a, Las Vegas, NM 87701 Phone: 505-617-6313 Fax: 505-617-6313 | |
Dr. Linda T Kennedy, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 509 11th St, Suite A, Las Vegas, NM 87701 Phone: 505-425-3155 Fax: 505-425-3155 | |
Theresa Carvell, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3695 Hot Springs Blvd, Las Vegas, NM 87701 Phone: 505-454-2100 |