MEDICARE: DAPA PSYCHIATRIC PROGRAMS, LLC

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	:	1477869899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAPA PSYCHIATRIC PROGRAMS, LLC

Provider Business Mailing Address
First Line	:	5500 GUHN RD
Second Line	:	SUITE 100
City	:	HOUSTON
State	:	TX
Zip	:	77040-6161
Country	:	US
Telephone Number	:	713-783-8889
Fax Number	:	713-783-0499

Provider Business Practice Location Address
First Line	:	310 REGAL ROW
Second Line	:	STE 300
City	:	DALLAS
State	:	TX
Zip	:	75247-5204
Country	:	US
Telephone Number	:	214-635-1790
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. DAVID R GAFFORD
Credential	:
Telephone Number	:	713-783-8889

Provider Enumeration Date	:	08/23/2010
Last Update Date	:	08/23/2010

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