Healthcare Provider Details

I. General information

NPI: 1114311768
Provider Name (Legal Business Name): NORTH TEXAS STATE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2015
Last Update Date: 03/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7985 STATE HIGHWAY 79 S
WICHITA FALLS TX
76310-0460
US

IV. Provider business mailing address

7985 STATE HIGHWAY 79 S
WICHITA FALLS TX
76310-0460
US

V. Phone/Fax

Practice location:
  • Phone: 940-447-0217
  • Fax:
Mailing address:
  • Phone: 940-447-0217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. LAUREN PARSONS
Title or Position: CLINICAL DIRECTOR-OPERATIONS
Credential: MD
Phone: 940-689-1220