Healthcare Provider Details

I. General information

NPI: 1942757026
Provider Name (Legal Business Name): EVEXIA PSYCHIATRY & RECOVERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18170 DALLAS PKWY SUITE 502
DALLAS TX
75287-7137
US

IV. Provider business mailing address

18170 DALLAS PKWY SUITE 502
DALLAS TX
75287-7137
US

V. Phone/Fax

Practice location:
  • Phone: 972-243-3343
  • Fax: 972-243-7324
Mailing address:
  • Phone: 972-243-3343
  • Fax: 972-243-7324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberQ4136
License Number StateTX

VIII. Authorized Official

Name: DR. JESSICA L. HUTTO
Title or Position: SOLE PROPRIETOR
Credential: M.D.
Phone: 972-243-3343