MEDICARE: PSY-MED, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133V00000X	Registered Dietitian
2	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian
3	103TH0004X	Health Psychologist

General Provider Information

NPI Number	:	1881842102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSY-MED, INC.

Provider Business Mailing Address
First Line	:	8140 WALNUT HILL LANE
Second Line	:	SUITE 308
City	:	DALLAS
State	:	TX
Zip	:	75231-4396
Country	:	US
Telephone Number	:	214-348-5557
Fax Number	:	214-348-5898

Provider Business Practice Location Address
First Line	:	8140 WALNUT HILL LANE
Second Line	:	SUITE 308
City	:	DALLAS
State	:	TX
Zip	:	75231-4396
Country	:	US
Telephone Number	:	214-348-5557
Fax Number	:	214-348-5898

Authorized Official
Title or Position	:	CEO
Name	:	MR. DWAYNE ANTHONY GUCCIONE
Credential	:
Telephone Number	:	214-536-1049

Provider Enumeration Date	:	08/28/2008
Last Update Date	:	04/06/2026

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Directions to “PSY-MED, INC. ” Practice Location

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