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General NPI Number Information
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NPI Number | 1760271829
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Entity Type | Organization
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Legal Business Name | ABCD PSYCHIATRY
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 163 TOWN PL STE 189
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City | FAIRVIEW
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State | TX
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Zip | 75069-1821
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Country | US
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Telephone | 469-833-7076
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Fax |
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Provider Business Mailing Address
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Address Line | 163 TOWN PL STE 189
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City | FAIRVIEW
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State | TX
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Zip | 75069-1821
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Country | US
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Telephone | 469-833-7076
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | TINA FAST
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Credential | NP
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Telephone | 469-833-7076
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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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