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General NPI Number Information
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NPI Number | 1891419842
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Entity Type | Organization
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Legal Business Name | TEXAS BEHAVIORAL HEALTH SYSTEMS, PLLC
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 7707 SAN JACINTO PL STE 300
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City | PLANO
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State | TX
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Zip | 75024-3377
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Country | US
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Telephone | 214-227-1300
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Fax | 214-227-1333
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Provider Business Mailing Address
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Address Line | PO BOX 2396
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City | FRISCO
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State | TX
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Zip | 75034-0044
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Country | US
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Telephone | 214-227-1300
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Fax | 214-227-1333
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW VICKERS
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Credential | APRN
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Telephone | 214-227-1300
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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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