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General NPI Number Information
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NPI Number | 1366155855
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Entity Type | Organization
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Legal Business Name | RESTOREME BEHAVIORAL HEALTH & WELLNESS PLLC
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Dates
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Enumeration Date | 12/30/2022
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Last Update Date | 12/30/2022
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Provider Practice Location Address
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Address Line | 7110 ASTER DR
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City | VENUS
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State | TX
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Zip | 76084-3753
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Country | US
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Telephone | 817-437-9885
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Fax |
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Provider Business Mailing Address
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Address Line | 7110 ASTER DR
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City | VENUS
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State | TX
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Zip | 76084-3753
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROWAN S TEBOH
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Credential |
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Telephone | 817-437-9885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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