| H. E. B. Behavioral Medicine, P. C. | |
|
305 Miron Dr Southlake TX 76092-7831 | |
| (817) 571-2899 | |
| (817) 571-9879 |
| Full Name | H. E. B. Behavioral Medicine, P. C. |
|---|---|
| Speciality | Psychologist |
| Location | 305 Miron Dr, Southlake, Texas |
| Authorized Official Name and Position | Dana Beth Turnbull (PRESIDENT, H. E. B. BEHAVIORAL MEDI) |
| Authorized Official Contact | 8175712899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| H. E. B. Behavioral Medicine, P. C. 12701 Beech Tree Ln Euless TX 76040-3427 Ph: (682) 553-8027 | H. E. B. Behavioral Medicine, P. C. 305 Miron Dr Southlake TX 76092-7831 Ph: (817) 571-2899 |
| NPI Number | 1114966074 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 08/21/2019 |
| Medicare PECOS PAC ID | 0749235885 |
|---|---|
| Medicare Enrollment ID | O20050322000296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114966074 | NPI | - | NPPES |
| 352891 | Other | TX | MHN |
| 37LJ | Other | TX | MAGELLAN HMO BLUE |
| 10011985 | Other | TX | AMERIGROUP CLAIMS |
| 2155975 | Other | TX | CIGNA BEHAVIORAL HEALTH |
| 195435 | Other | TX | AMERIGROUP |
| 224689 | Other | TX | TEXAS REHAB COMMISSION |
| 00478Y | Other | TX | MEDICARE PTAN |
| 489437 | Other | TX | VALUE OPTIONS |
| 0417750-04 | Other | TX | TEXAS STAR |
| 86960A | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 31454 (Texas) | Primary |
| Provider Name | Dana Turnbull |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558304691 PECOS PAC ID: 3274588314 Enrollment ID: I20050322000307 |
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