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General NPI Number Information
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NPI Number | 1568252757
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Entity Type | Organization
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Legal Business Name | DFW NEUROPSYCHOLOGY CONSULTANTS LLC
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 600 E JOHN CARPENTER FWY STE 273
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City | IRVING
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State | TX
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Zip | 75062-4319
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Country | US
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Telephone | 469-444-3226
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Fax | 469-208-0240
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Provider Business Mailing Address
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Address Line | 600 E JOHN CARPENTER FWY STE 273
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City | IRVING
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State | TX
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Zip | 75062-4319
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Country | US
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Telephone | 469-444-3226
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RENJAN ROY MATHEW
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Credential | PHD.
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Telephone | 469-585-5393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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