MEDICARE: ROBERT F MEHL III PHD & ASSOC LLC

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	261QM1300X	Multi-Specialty Clinic/Center		TX

General Provider Information

NPI Number	:	1912999715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT F MEHL III PHD & ASSOC LLC

Provider Business Mailing Address
First Line	:	2237 RIDGE RD
Second Line	:	STE 101
City	:	ROCKWALL
State	:	TX
Zip	:	75087-5164
Country	:	US
Telephone Number	:	972-771-3969
Fax Number	:	972-771-8258

Provider Business Practice Location Address
First Line	:	2237 RIDGE RD
Second Line	:	STE 101
City	:	ROCKWALL
State	:	TX
Zip	:	75087-5164
Country	:	US
Telephone Number	:	972-771-3969
Fax Number	:	972-771-8258

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. ROBERT F MEHL III
Credential	:	PHD
Telephone Number	:	972-771-3969

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	07/21/2022

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