Healthcare Provider Details

I. General information

NPI: 1083245922
Provider Name (Legal Business Name): SBATES CREATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 N COLLINS BLVD STE 206C
RICHARDSON TX
75080-3625
US

IV. Provider business mailing address

120 EAST FM 544 STE 72 PMB 153
MURPHY TX
75094
US

V. Phone/Fax

Practice location:
  • Phone: 469-409-1212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHELLY BATES
Title or Position: OWNER
Credential:
Phone: 469-409-1212