Healthcare Provider Details

I. General information

NPI: 1821834045
Provider Name (Legal Business Name): TEXAS TREATMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 HEMPHILL ST STE A
FORT WORTH TX
76104-3105
US

IV. Provider business mailing address

700 HEMPHILL ST STE A
FORT WORTH TX
76104-3105
US

V. Phone/Fax

Practice location:
  • Phone: 817-334-0111
  • Fax:
Mailing address:
  • Phone: 817-334-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MELISSA FLORES
Title or Position: PROGRAM DIRECTOR
Credential: MSW, LCDC
Phone: 817-334-0111