Healthcare Provider Details

I. General information

NPI: 1033565437
Provider Name (Legal Business Name): ALEFIYAH BHARMAL PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E ROYAL LN STE 290
IRVING TX
75039-3602
US

IV. Provider business mailing address

6854 SONOMA
IRVING TX
75039-3074
US

V. Phone/Fax

Practice location:
  • Phone: 972-937-8165
  • Fax: 469-532-0253
Mailing address:
  • Phone: 210-723-7869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number37153
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number37153
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number37153
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: