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General NPI Number Information
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NPI Number | 1962129288
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Entity Type | Organization
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Legal Business Name | ROANN BEHAVIORAL HEALTH CLINIC PLLC
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 6500 NORTHWEST DR STE 350E
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City | MESQUITE
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State | TX
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Zip | 75150-6849
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Country | US
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Telephone | 214-272-3167
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Fax | 214-272-3749
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Provider Business Mailing Address
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Address Line | 6500 NORTHWEST DR STE 350E
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City | MESQUITE
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State | TX
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Zip | 75150-6849
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Country | US
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Telephone | 214-272-3167
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Fax | 214-272-3749
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | EKEOMA COOPER
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Credential |
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Telephone | 214-272-3167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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