Healthcare Provider Details

I. General information

NPI: 1285538470
Provider Name (Legal Business Name): D-BALM PSYCHIATRIC HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E BROAD ST STE 101
MANSFIELD TX
76063-6914
US

IV. Provider business mailing address

1507 WILD INDIGO DR
MANSFIELD TX
76063-4688
US

V. Phone/Fax

Practice location:
  • Phone: 682-556-6779
  • Fax:
Mailing address:
  • Phone: 682-556-6779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: FOLUKEMI OLAWEPO
Title or Position: ADMINISTRATOR
Credential: PMHNP-BC
Phone: 682-556-6779