MEDICARE: GEODE HEALTH OF TEXAS, 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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1851037162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEODE HEALTH OF TEXAS, PLLC

Provider Business Mailing Address
First Line	:	1211 W 22ND ST STE 406
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-2169
Country	:	US
Telephone Number	:	630-571-6077
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 S WATTERS RD STE 130
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-5008
Country	:	US
Telephone Number	:	469-854-3263
Fax Number	:	630-912-4241

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	BRANDY L MARRINER
Credential	:
Telephone Number	:	630-912-4241

Provider Enumeration Date	:	05/10/2022
Last Update Date	:	03/04/2026

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