Healthcare Provider Details

I. General information

NPI: 1225395395
Provider Name (Legal Business Name): ENTERHEALTH OUTPATIENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 04/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 DOUGLAS AVE STE 375
DALLAS TX
75225-5973
US

IV. Provider business mailing address

8222 DOUGLAS AVE STE 375
DALLAS TX
75225-5973
US

V. Phone/Fax

Practice location:
  • Phone: 214-905-5090
  • Fax: 214-905-1998
Mailing address:
  • Phone: 214-905-5090
  • Fax: 214-905-1998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. HAROLD URSCHEL III
Title or Position: CHEIF MEDICAL STRATEGIST
Credential: MD
Phone: 214-905-5090