=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104769751
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RESTORED HEARTS COUNSELING OF TEXAS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1218 FM 381
-----------------------------------------------------
City | ROWENA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76875-4008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-208-4908
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1218 FM 381
-----------------------------------------------------
City | ROWENA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76875-4008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-208-4908
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | ANTHONY FRASCO
-----------------------------------------------------
Credential | FRASCO
-----------------------------------------------------
Telephone | 316-208-4908
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------