| Roann Behavioral Health Clinic Pllc | |
|
6500 Northwest Dr Ste 350e Mesquite TX 75150-6849 | |
| (214) 272-3167 | |
| (214) 272-3749 |
| Full Name | Roann Behavioral Health Clinic Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6500 Northwest Dr Ste 350e, Mesquite, Texas |
| Authorized Official Name and Position | Ekeoma Cooper (PRACTICE MANAGER) |
| Authorized Official Contact | 2142723167 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roann Behavioral Health Clinic Pllc 6500 Northwest Dr Ste 350e Mesquite TX 75150-6849 Ph: (214) 272-3167 | Roann Behavioral Health Clinic Pllc 6500 Northwest Dr Ste 350e Mesquite TX 75150-6849 Ph: (214) 272-3167 |
| NPI Number | 1962129288 |
|---|---|
| Provider Enumeration Date | 10/26/2022 |
| Last Update Date | 11/21/2022 |
| Certification Date | 11/21/2022 |
| Medicare PECOS PAC ID | 5294192092 |
|---|---|
| Medicare Enrollment ID | O20230609002489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962129288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ekeoma I Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578029534 PECOS PAC ID: 1557693470 Enrollment ID: I20191025002618 |
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