Individual
JOE MAC JEFFERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
3471 KNICKERBOCKER RD, STE 508, SAN ANGELO, TX 76904-8826
(325) 942-7531
(325) 942-7532
Mailing address
1517 DARLENE ST, SAN ANGELO, TX 76904-9005
(325) 942-8191
(325) 942-7532
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
21733
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117880
SUPERIOR HEALTHPLAN NETWO
TX
01
—
130095
MHN/HMC CLAIMS
TX
Enumeration date
06/22/2005
Last updated
07/08/2007
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