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NPI Code Detail

MEDICARE: ONE TRIBE FOUNDATION

MEDICARE: ONE TRIBE FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1033733266
Entity Type Code : Organization
Provider Name (Legal Business Name) : ONE TRIBE FOUNDATION
Provider Business Mailing Address
First Line : 13625 NEUTRON RD
Second Line :
City : DALLAS
State : TX
Zip : 75244-4411
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 855 TEXAS ST STE 105
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-4574
Country : US
Telephone Number : 682-990-6242
Fax Number :
Authorized Official
Title or Position : CONSULTANT
Name : ANDREW CARLTON
Credential :
Telephone Number : 817-996-5867
Provider Enumeration Date : 06/03/2020
Last Update Date : 06/03/2020

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Directions to “ONE TRIBE FOUNDATION ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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