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General NPI Number Information
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NPI Number | 1699539346
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Entity Type | Organization
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Legal Business Name | JOURNEY CLINICAL PSYCHIATRY TX PC
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 12600 HILL COUNTRY BLVD STE R-275
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City | BEE CAVE
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State | TX
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Zip | 78738-6768
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Country | US
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Telephone | 917-274-7730
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Fax |
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Provider Business Mailing Address
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Address Line | 80 5TH AVE FL 18
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City | NEW YORK
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State | NY
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Zip | 10011-8002
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Country | US
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Telephone | 917-274-7730
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | KYLE LAPIDUS
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Credential |
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Telephone | 917-274-7730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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