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NPI Code Detail

MEDICARE: YOLANDA BRUCE BROOKS, PSY.D

MEDICARE: YOLANDA BRUCE BROOKS, PSY.D
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
1103TC0700XClinical Psychologist2-4386TX

General Provider Information

NPI Number : 1740558980
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOLANDA BRUCE BROOKS, PSY.D
Provider Business Mailing Address
First Line : PO BOX 800328
Second Line :
City : DALLAS
State : TX
Zip : 75380-0328
Country : US
Telephone Number : 972-233-2360
Fax Number :
Provider Business Practice Location Address
First Line : 4100 ALPHA RD STE 1150
Second Line :
City : DALLAS
State : TX
Zip : 75244-4335
Country : US
Telephone Number : 972-233-2360
Fax Number :
Authorized Official
Title or Position : OWNER
Name : YOLANDA BRUCE BROOKS
Credential : PSY.D
Telephone Number : 972-233-2360
Provider Enumeration Date : 12/02/2011
Last Update Date : 12/02/2011

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