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General NPI Number Information
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NPI Number | 1619849817
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Entity Type | Individual
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Provider Name | TIWATOPE BANKALE PHD
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Gender | Female
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 534 E PLEASANT RUN RD
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City | DESOTO
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State | TX
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Zip | 75115-4002
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Country | US
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Telephone | 469-488-5000
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Fax | 469-990-5333
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Provider Business Mailing Address
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Address Line | 534 E PLEASANT RUN RD
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City | DESOTO
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State | TX
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Zip | 75115-4002
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Country | US
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Telephone | 469-488-5000
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Fax | 469-990-5333
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | 40725
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 40725
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License Number State | TX
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