Healthcare Provider Details
I. General information
NPI: 1023932522
Provider Name (Legal Business Name): PMA / AADHAR
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6404 INTERNATIONAL PKWY STE 1010
PLANO TX
75093-8346
US
IV. Provider business mailing address
6404 INTERNATIONAL PKWY STE 1010
PLANO TX
75093-8346
US
V. Phone/Fax
- Phone: 214-249-9210
- Fax: 214-249-9210
- Phone: 214-249-9210
- Fax: 214-249-9210
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEANNE
MONTILLA
Title or Position: RN
Credential: BSN, RN
Phone: 214-249-9210