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General NPI Number Information
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NPI Number | 1174861983
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Entity Type | Organization
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Legal Business Name | BASEPOINT PSYCHIATRY AND WELLNESS
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 713 W BROAD ST
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City | FORNEY
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State | TX
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Zip | 75126-9147
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Country | US
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Telephone | 972-552-5559
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Fax | 972-552-5499
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Provider Business Mailing Address
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Address Line | 713 W BROAD ST
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City | FORNEY
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State | TX
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Zip | 75126-9147
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Country | US
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Telephone | 972-325-2584
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Fax | 972-552-5499
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Authorized Official
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Title or Position | COO
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Name | BLAKE SERPA
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Credential |
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Telephone | 214-793-0636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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