MEDICARE: MR. URI TALMOR MA, LPC

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	101YM0800X	Mental Health Counselor	64442	TX

General Provider Information

NPI Number	:	1487892618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. URI TALMOR MA, LPC

Provider Business Mailing Address
First Line	:	3536 BEE CAVES RD STE 214
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5474
Country	:	US
Telephone Number	:	512-695-4495
Fax Number	:	702-926-9968

Provider Business Practice Location Address
First Line	:	3536 BEE CAVES RD STE 214
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5474
Country	:	US
Telephone Number	:	512-695-4495
Fax Number	:	702-926-9968

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

Provider Enumeration Date	:	01/26/2009
Last Update Date	:	01/26/2009

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