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906 Palomino Dr Euless TX 76039-3960 | |
| (817) 684-1996 | |
| (817) 358-9577 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 906 Palomino Dr, Euless, Texas |
| Authorized Official Name and Position | Mark Joseph Smith (ADMINISTRATOR) |
| Authorized Official Contact | 8176841996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1452 Hughes Rd Ste 200 Grapevine TX 76051-7367 Ph: (817) 684-1996 | 906 Palomino Dr Euless TX 76039-3960 Ph: (817) 684-1996 |
| NPI Number | 1083891634 |
|---|---|
| Provider Enumeration Date | 01/25/2008 |
| Last Update Date | 01/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083891634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 011024 (Texas) | Primary |
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