Unknown Individual – Psychiatry Physician, NPI 1639103104
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
PO BOX 670548
DALLAS, TX 753670548
Phone: (214) 477-2233
Type: Mailing
2018 Pulliam St
San Angelo, TX 769055148
Phone: (325) 659-7300
Type: Location
11107, Lawnhaven Road, Dallas, Dallas County, Texas, 75230, United States
GUEST HOUSE LEFT REAR
DALLAS, TX 752303549
Phone: (214) 477-2233
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75367)
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