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NPI Code Detail

MEDICARE: MRS. FELICIA RENE' NEVAREZ LCSW

MEDICARE: MRS. FELICIA RENE' NEVAREZ LCSW
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
11041C0700XClinical Social Worker35847TX

General Provider Information

NPI Number : 1609063684
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FELICIA RENE' NEVAREZ LCSW
Provider Business Mailing Address
First Line : 3611 SWISS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75204-6245
Country : US
Telephone Number : 214-818-2602
Fax Number : 214-818-2645
Provider Business Practice Location Address
First Line : 4001 W 15TH ST STE 465
Second Line :
City : PLANO
State : TX
Zip : 75093-5845
Country : US
Telephone Number : 214-557-1798
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2007
Last Update Date : 11/17/2020

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