MEDICARE: JONI ADAMS PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	32475	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8D9982	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255374195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONI ADAMS PSYD

Provider Business Mailing Address
First Line	:	9920 CYPRESSWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3400
Country	:	US
Telephone Number	:	281-955-5585
Fax Number	:

Provider Business Practice Location Address
First Line	:	1956 AUGUSTA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-3742
Country	:	US
Telephone Number	:	713-614-5141
Fax Number	:	832-548-1981

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	06/23/2016

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