NORTH TEXAS BRAIN AND WELLNESS, INC. (NPI# 1952958274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952958274 |
Entity Type | Organization |
Organization Name | NORTH TEXAS BRAIN AND WELLNESS, INC. |
Practice Address |
731 E Southlake Blvd Ste 170 Southlake TX 76092-6382 |
Mailing Address |
Po Box 470606 Fort Worth TX 76147-0606 |
Practice Telephone | 8175807678 |
Practice Fax Number | 8175807891 |
Mailing Telephone | 8175807678 |
Mailing Fax Number | 8175807891 |
Enumeration Date | 2019-08-21 |
Last Update Date | 2020-04-21 |
Authorized Official Name | LAURA ASHLEY ESCOTO (PRESIDENT) |
Authorized Official Telephone | 8175807678 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
Allopathic & Osteopathic Physicians | ||
N | 2084P0301X |
Psychiatry & Neurology Specialization: Brain Injury Medicine |
Allopathic & Osteopathic Physicians | ||
N | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
N | 2084N0008X |
Psychiatry & Neurology Specialization: Neuromuscular Medicine |
Allopathic & Osteopathic Physicians | ||
N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
N | 111N00000X | Chiropractor | Chiropractic Providers | ||
N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
Street Address |
731 E SOUTHLAKE BLVD STE 170 |
City | SOUTHLAKE |
State | TX |
Zip Code | 76092-6382 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326152851 | Simon S Tan, Md Pa | Psychiatry & Neurology | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2006-08-19 |
1508377441 | Journey Tech | Psychiatry & Neurology | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2017-10-18 |
1033620976 | Voyage Monitoring, Pllc | Specialist | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2017-10-18 |
1467961961 | Kinsley Consulting LLC | Surgery | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2017-09-27 |
1104344688 | Neurocare Centre of North Texas, Pllc | Psychiatry & Neurology | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2017-09-05 |
1720504780 | Handsurg. Pllc | Surgery | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2017-08-21 |
1205244191 | Manos Monitoring, Pllc | Psychiatry & Neurology | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2014-07-24 |
1871900183 | Kara Michelle Kramer | Nurse Practitioner | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2014-07-18 |
1639351216 | Dustin L. Ray | Surgery | 731 E Southlake Blvd Ste 170, Southlake, TX 76092-6382 | 2007-12-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
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Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467082438 | Proliferativemed Pllc | Clinic/Center | 731 E Southlake Blvd Ste 110, Southlake, TX 76092-6378 | 2020-01-18 |
1336651074 | Healthworks Med Group of Texas Darlington P A | Clinic/Center | 3120 Sabre Dr, Southlake, TX 76092-2103 | 2017-11-03 |
1730664657 | Gcr Integrated Health Pllc | Clinic/Center | 100 W Southlake Blvd Ste 410, Southlake, TX 76092-6166 | 2018-09-26 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.