MEDICARE: NDC SERVICES, PLLC

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	101YP2500X	Professional Counselor	65842	TX

General Provider Information

NPI Number	:	1891203881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NDC SERVICES, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 164
Second Line	:
City	:	BUSHLAND
State	:	TX
Zip	:	79012-0164
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 OLSEN BLVD STE 216
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79109-3032
Country	:	US
Telephone Number	:	806-681-5943
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	CHRISTIN HALL
Credential	:	LPC
Telephone Number	:	806-681-5943

Provider Enumeration Date	:	01/12/2018
Last Update Date	:	01/23/2018

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