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General NPI Number Information
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NPI Number | 1356216022
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Entity Type | Organization
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Legal Business Name | OPTUM BEHAVIORAL CARE OF TEXAS, P.A.
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 1311 W PRESIDENT GEORGE BUSH HWY STE 100
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City | RICHARDSON
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State | TX
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Zip | 75080-1152
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Country | US
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Telephone | 877-622-0013
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Fax |
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Provider Business Mailing Address
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Address Line | 1311 W PRESIDENT GEORGE BUSH HWY STE 100
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City | RICHARDSON
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State | TX
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Zip | 75080-1152
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Country | US
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Telephone | 877-622-0013
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | AMANDA STACEY BRONSON
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Credential |
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Telephone | 978-222-3121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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