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General NPI Number Information
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NPI Number | 1740076413
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Entity Type | Organization
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Legal Business Name | MINDGLAMOUR PLLC
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 1230 RIVER BEND DR STE 218
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City | DALLAS
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State | TX
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Zip | 75247-4993
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Country | US
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Telephone | 469-401-5133
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Fax |
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Provider Business Mailing Address
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Address Line | 3763 ROYAL LN
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City | DALLAS
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State | TX
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Zip | 75229-3950
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Country | US
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Telephone | 972-987-6184
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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. CONSUELA DENISE HARRIS
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Credential |
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Telephone | 469-401-5133
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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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