Individual
MIGUEL L DESOCARRAZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
503 LAKEWOOD ST, ROCKPORT, TX 78382-6958
(361) 779-6472
(361) 729-1467
Mailing address
503 LAKEWOOD ST, ROCKPORT, TX 78382-6958
(361) 779-6472
(361) 729-1467
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
21513
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00HR73
BCBS OF TX
TX
05
—
033905301
—
TX
Enumeration date
10/10/2005
Last updated
07/28/2010
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