Healthcare Provider Details

I. General information

NPI: 1053825802
Provider Name (Legal Business Name): PEI YIH BRYAN TZENG PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2017
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8098 PRECINCT LINE RD # 110
COLLEYVILLE TX
76034-7693
US

IV. Provider business mailing address

8098 PRECINCT LINE RD STE 110
COLLEYVILLE TX
76034-7694
US

V. Phone/Fax

Practice location:
  • Phone: 682-231-3104
  • Fax:
Mailing address:
  • Phone: 817-778-9232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number71335
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number71335
License Number StateTX

VIII. Authorized Official

Name: PEI-YIH BRYAN TZENG
Title or Position: OWNER/THERAPIST
Credential: LPC
Phone: 817-992-4526