Tex W Anderson Jr., TRADITIONAL PRACTITI

Individual provider Active NPI Counselor · Crownpoint, NM

NPI 1811280704 · NPPES record last updated Jul 31, 2019

Key facts

NPI
1811280704
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
2314 Southwest Highland Drive
Crownpoint, NM 87313
Phone
(505) 786-2111
Fax
(505) 786-2020
NPI assigned
May 25, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Navajo Nation Crownpoint Outpatient Treatment Center Past
since Aug 6, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NM Yes

Addresses

Primary practice location

2314 Southwest Highland Drive
Crownpoint, NM 87313

Mailing address

PO Box 1144
Crownpoint, NM 87313-1144
Phone (505) 786-2111

Other practice location 1

.5 miles off HWY 371
Thoreau, NM 87323-1289
Phone (505) 905-0061

Other identifiers

IdentifierTypeStateIssuer
860092335OtherNMBEHAVIORAL HEALTH SERVICE

Other providers in Crownpoint, NM

All providers in Crownpoint, NM · Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.