MEDICARE: PLANET HEALTHCARE SERVICES

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1477390953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANET HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	2845 CLEAR CREEK DR
Second Line	:
City	:	ROCKWALL
State	:	TX
Zip	:	75032-9249
Country	:	US
Telephone Number	:	469-257-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 HIGHLAND RD STE 105
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-7165
Country	:	US
Telephone Number	:	469-257-3500
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DOROTHY NJIDEKA NWANNE
Credential	:	NP
Telephone Number	:	469-257-3500

Provider Enumeration Date	:	07/11/2024
Last Update Date	:	11/07/2025

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Directions to “PLANET HEALTHCARE SERVICES ” Practice Location

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