Healthcare Provider Details

I. General information

NPI: 1124140058
Provider Name (Legal Business Name): ANTOINETTE ROSE MCGARRAHAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12820 HILLCREST RD STE C125
DALLAS TX
75230-1526
US

IV. Provider business mailing address

12820 HILLCREST RD STE C125
DALLAS TX
75230-1526
US

V. Phone/Fax

Practice location:
  • Phone: 972-726-9100
  • Fax: 972-726-9101
Mailing address:
  • Phone: 972-726-9100
  • Fax: 972-726-9101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number31397
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: