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DR. JOHN WALTER BORDAGES PH.D.

Clinical Neuropsychologist

Beaumont, Texas

Provider NPI: 1740380732

Provider Information:
DR. JOHN WALTER BORDAGES PH.D.
Gender: M
Sole Proprietor


Practice Location:
6870 PHELAN BLVD  BEAUMONT, TX 77706 US
Tel: 409-861-1181  Fax: 409-861-1166

Business Mailing Address:
6870 PHELAN BLVD  BEAUMONT, TX 77706 US
Tel: 409-861-1181  Fax: 409-861-1166

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
Clinical
TX25056

Other Provider Identifiers:

IssuerNumberStateType
1236358 02TX05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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