| Mindforge Psychiatry, Pllc | |
|
950 E Highway 114 Suite 160 Southlake TX 76092 | |
| (951) 796-5464 | |
| Not Available |
| Full Name | Mindforge Psychiatry, Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 950 E Highway 114, Southlake, Texas |
| Authorized Official Name and Position | Brian W Mendenhall (PHYSICIAN) |
| Authorized Official Contact | 9517965454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindforge Psychiatry, Pllc 950 E Highway 114 Suite 160 Southlake TX 76092 Ph: (951) 796-5464 | Mindforge Psychiatry, Pllc 950 E Highway 114 Suite 160 Southlake TX 76092 Ph: (951) 796-5464 |
| NPI Number | 1013748037 |
|---|---|
| Provider Enumeration Date | 08/12/2024 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013748037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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