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General NPI Number Information
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NPI Number | 1144958802
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Entity Type | Organization
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Legal Business Name | NCC ENDEAVOR PLLC
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 3901 W GREEN OAKS BLVD STE B
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City | ARLINGTON
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State | TX
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Zip | 76016-2789
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Country | US
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Telephone | 682-532-9600
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Fax | 817-668-0527
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Provider Business Mailing Address
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Address Line | 4200 COUNTRY HILL RD
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City | FT WORTH
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State | TX
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Zip | 76140-8500
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Country | US
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Telephone | 817-688-3386
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CONNIE M DUNN
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Credential | PH.D.
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Telephone | 817-688-3386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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