Provider Demographics
NPI:1255427548
Name:MCALLEN PSYCHOLOGICAL CENTER
Entity type:Organization
Organization Name:MCALLEN PSYCHOLOGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YSAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:956-460-4223
Mailing Address - Street 1:9601 N 10TH ST UNIT 29
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-9423
Mailing Address - Country:US
Mailing Address - Phone:956-687-1833
Mailing Address - Fax:
Practice Address - Street 1:9601 N 10TH ST UNIT 29
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-9423
Practice Address - Country:US
Practice Address - Phone:956-687-1833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N41NOtherBLUE CROSS BLUE SHIELD
TX084173601Medicaid
TX00N41NMedicare PIN