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General NPI Number Information
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NPI Number | 1366203028
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Entity Type | Organization
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Legal Business Name | DEMENTIA CARE TX PLLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 23 WOOD MANOR PL
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City | THE WOODLANDS
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State | TX
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Zip | 77381-2803
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Country | US
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Telephone | 407-690-6254
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Fax |
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Provider Business Mailing Address
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Address Line | 1032 E BRANDON BLVD # 7437
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City | BRANDON
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State | FL
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Zip | 33511-5509
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Country | US
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Telephone | 407-690-6254
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | JONATHAN AMOS
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Credential |
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Telephone | 646-406-9347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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