| Restore Brain, Pllc | |
|
5207 Heritage Ave Colleyville TX 76034-5915 | |
| (888) 990-0663 | |
| (888) 990-0663 |
| Full Name | Restore Brain, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5207 Heritage Ave, Colleyville, Texas |
| Authorized Official Name and Position | David Cichy (PRACTICE BUSINESS MANAGER) |
| Authorized Official Contact | 2145626364 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Brain, Pllc 4643 Westgrove Dr Addison TX 75001-3216 Ph: (214) 562-6364 | Restore Brain, Pllc 5207 Heritage Ave Colleyville TX 76034-5915 Ph: (888) 990-0663 |
| NPI Number | 1154839470 |
|---|---|
| Provider Enumeration Date | 01/22/2018 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 7517200769 |
|---|---|
| Medicare Enrollment ID | O20190510001036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154839470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (Texas) | Primary |
| Provider Name | Arturo C Taca |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295846319 PECOS PAC ID: 9739187683 Enrollment ID: I20190510001059 |
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