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8330 Abrams Rd Ste 112 Dallas TX 75243-7590 | |
| (214) 342-4400 | |
| (214) 342-4401 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 8330 Abrams Rd Ste 112, Dallas, Texas |
| Authorized Official Name and Position | Laura Carr (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 2144566715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 844582 Dallas TX 75284-4582 Ph: (214) 456-4550 | 8330 Abrams Rd Ste 112 Dallas TX 75243-7590 Ph: (214) 342-4400 |
| NPI Number | 1215231881 |
|---|---|
| Provider Enumeration Date | 12/22/2010 |
| Last Update Date | 10/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215231881 | NPI | - | NPPES |
| 200950816 | Medicaid | TX | |
| 200950817 | Medicaid | TX | |
| 324083008 | Medicaid | TX | |
| 324083007 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
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