Unknown Individual – Psychiatry Physician, NPI 1124191762
Psychiatry Physician
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Provider Addresses for Unknown Individual
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
DALLAS, TX 753732973
Phone: (817) 702-8450
Type: Mailing
1500 S Main St
Fort Worth, TX 761044917
Phone: (817) 702-3636
Fax: (817) 927-8769
Type: Location
1175, Carondelet Drive, Tri-Cities, Benton County, Washington, 99354, United States
RICHLAND, WA 993543300
Phone: (509) 943-9104
Type: Location
NPPES updates history
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75373)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | WA | 90833 | Psychotherapy, 30 minutes with patient and/or family member | 141 | 41 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| Mental Health Counselor | WA | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | WA | |
| Clinical Social Worker | WA | |
| General Surgery | NY | |
| Internal Medicine, Pulmonary Disease, Critical Care (Intensivists) | WA | |
| Physician Assistant | WA | |
| - | WA | |
| Physical Therapist In Private Practice | OR |
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