| Minds Of Gold | |
|
4645 Wyndham Ln Ste 240 Frisco TX 75033-0025 | |
| (972) 292-0533 | |
| Not Available |
| Full Name | Minds Of Gold |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4645 Wyndham Ln Ste 240, Frisco, Texas |
| Authorized Official Name and Position | Tonika Laflora (PRESIDENT) |
| Authorized Official Contact | 9722920533 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minds Of Gold 709 Cherry Blossom St Anna TX 75409-5006 Ph: (972) 292-0533 | Minds Of Gold 4645 Wyndham Ln Ste 240 Frisco TX 75033-0025 Ph: (972) 292-0533 |
| NPI Number | 1336855113 |
|---|---|
| Provider Enumeration Date | 01/25/2023 |
| Last Update Date | 01/25/2023 |
| Certification Date | 01/25/2023 |
| Medicare PECOS PAC ID | 6608212188 |
|---|---|
| Medicare Enrollment ID | O20240306003078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336855113 | NPI | - | NPPES |
| 114569167 | Other | CA | PROVIDER NPI # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Tonika Ludell Laflora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114569167 PECOS PAC ID: 4284068917 Enrollment ID: I20231212000873 |
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