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General NPI Number Information
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NPI Number | 1851166961
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Entity Type | Organization
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Legal Business Name | SUMMIT RIDGE PSYCHIATRY PLLC
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 6205 LA VISTA DR
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City | DALLAS
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State | TX
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Zip | 75214-4312
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Country | US
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Telephone | 469-273-1540
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Fax |
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Provider Business Mailing Address
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Address Line | 5555 EMERSON CT
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City | FAIRVIEW
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State | TX
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Zip | 75069-6808
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Country | US
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Telephone | 469-273-1540
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEAN COCHRAN
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Credential | PMHNP-BC
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Telephone | 469-273-1540
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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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