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General NPI Number Information
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NPI Number | 1417864455
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Entity Type | Organization
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Legal Business Name | DFW DRUG REHAB, LLC
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 1110 W WILLIAM CANNON DR BLDG 2
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City | AUSTIN
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State | TX
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Zip | 78745-5468
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Country | US
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Telephone | 214-494-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 W WILLIAM CANNON DR BLDG 2
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City | AUSTIN
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State | TX
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Zip | 78745-5468
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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 | CFO
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Name | LUKE MILLER
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Credential |
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Telephone | 214-494-0693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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