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General NPI Number Information
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NPI Number | 1881408474
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Entity Type | Organization
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Legal Business Name | PEACE-LILY PSYCHIATRY AND MENTAL HEALTH SERVICES PLLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 1341 W MOCKINGBIRD LN
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City | DALLAS
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State | TX
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Zip | 75247-6913
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Country | US
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Telephone | 469-743-8375
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Fax |
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Provider Business Mailing Address
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Address Line | 2528 CHERRY DR
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City | LITTLE ELM
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State | TX
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Zip | 75068-5668
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Country | US
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Telephone | 972-827-5709
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | PEACE DZANYIKPOR
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Credential |
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Telephone | 972-827-5709
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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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