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General NPI Number Information
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NPI Number | 1942014972
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Entity Type | Organization
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Legal Business Name | TUMAINI PSYCHIATRY PLLC
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Dates
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Enumeration Date | 02/01/2025
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 2300 VALLEY VIEW LN
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City | IRVING
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State | TX
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Zip | 75062-1721
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Country | US
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Telephone | 682-593-0477
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Fax | 682-593-0447
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Provider Business Mailing Address
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Address Line | 539 W COMMERCE ST # 3213
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City | DALLAS
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State | TX
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Zip | 75208-1953
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Country | US
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Telephone | 682-593-0477
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Fax | 682-593-0447
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Authorized Official
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Title or Position | PMHNP
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Name | GRACE SYOMBUA JEDIDAH
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Credential |
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Telephone | 682-593-0477
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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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