MEDICARE: EMPOWER MIND PLLC

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
1	273R00000X	Psychiatric Hospital Unit
2	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1144973355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWER MIND PLLC

Provider Business Mailing Address
First Line	:	400 STONEBROOK PKWY UNIT 205
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75036-1181
Country	:	US
Telephone Number	:	469-977-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 STONEBROOK PKWY UNIT 205
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75036-1181
Country	:	US
Telephone Number	:	469-977-1100
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RESHMI DUTTA
Credential	:
Telephone Number	:	972-977-8388

Provider Enumeration Date	:	01/28/2022
Last Update Date	:	02/13/2024

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Directions to “EMPOWER MIND PLLC ” Practice Location

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