Provider Demographics
NPI:1871215848
Name:ACCESS PSYCHIATRY WACO PLLC
Entity type:Organization
Organization Name:ACCESS PSYCHIATRY WACO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN, PMHNP-BC OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGUERITE 'PEGGY'
Authorized Official - Middle Name:W
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:817-999-3030
Mailing Address - Street 1:8414 OLD MCGREGOR RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6496
Mailing Address - Country:US
Mailing Address - Phone:254-294-2887
Mailing Address - Fax:254-233-8878
Practice Address - Street 1:8414 OLD MCGREGOR RD UNIT B
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6496
Practice Address - Country:US
Practice Address - Phone:254-294-2887
Practice Address - Fax:254-233-8878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-15
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1366688301OtherNPPES NPI TYPE1