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NPI 1467227827

NPI 1467227827 : BRIGHTPATH PSYCHIATRY AND BEHAVIORAL HEALTH SERVICES : MESQUITE, TX

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General NPI Number Information
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    NPI Number           |    1467227827
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    Entity Type          |    Organization 
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    Legal Business Name  |    BRIGHTPATH PSYCHIATRY AND BEHAVIORAL HEALTH SERVICES 
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Dates
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    Enumeration Date     |    11/16/2023
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    Last Update Date     |    11/16/2023
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Provider Practice Location Address
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    Address Line         |    3939 US HIGHWAY 80 E 
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    City                 |    MESQUITE
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    State                |    TX
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    Zip                  |    75150-3359
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    Country              |    US
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    Telephone            |    469-471-7839
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3939 US HIGHWAY 80 E 
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    City                 |    MESQUITE
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    State                |    TX
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    Zip                  |    75150-3359
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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                 |     613529  613529 
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    Credential           |    
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    Telephone            |    469-471-7839
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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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