| Prestonwood Counseling Center | |
|
15400 Knoll Trail Dr Suite 109 Dallas TX 75248-3467 | |
| (972) 248-4673 | |
| (973) 392-9041 |
| Full Name | Prestonwood Counseling Center |
|---|---|
| Speciality | Counselor - Professional |
| Location | 15400 Knoll Trail Dr, Dallas, Texas |
| Authorized Official Name and Position | Richard Alan Fowler (PRESIDENT) |
| Authorized Official Contact | 9722484673 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestonwood Counseling Center 15400 Knoll Trail Dr Suite 109 Dallas TX 75248-3467 Ph: (972) 248-4673 | Prestonwood Counseling Center 15400 Knoll Trail Dr Suite 109 Dallas TX 75248-3467 Ph: (972) 248-4673 |
| NPI Number | 1043382062 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043382062 | NPI | - | NPPES |
| 80752L | Other | TX | BLUE CROSS BLUE SHIELD # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 03231 (Texas) | Primary |
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