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General NPI Number Information
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NPI Number | 1083216212
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Entity Type | Individual
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Provider Name | DAVID TRICE M.ED, LPC
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Gender | Male
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 4201 HERITAGE TRACE PKWY
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City | FORT WORTH
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State | TX
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Zip | 76244-6026
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Country | US
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Telephone | 817-900-0376
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Fax |
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Provider Business Mailing Address
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Address Line | 417 LONESOME PRAIRIE TRL
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City | HASLET
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State | TX
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Zip | 76052-4190
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Country | US
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Telephone | 817-301-3243
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 74955
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License Number State | TX
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