MEDICARE: EVEXIA PSYCHIATRY & RECOVERY, 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	261QM0850X	Adult Mental Health Clinic/Center	Q4136	TX

General Provider Information

NPI Number	:	1942757026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVEXIA PSYCHIATRY & RECOVERY, PLLC

Provider Business Mailing Address
First Line	:	18170 DALLAS PKWY
Second Line	:	SUITE 502
City	:	DALLAS
State	:	TX
Zip	:	75287-7137
Country	:	US
Telephone Number	:	972-243-3343
Fax Number	:	972-243-7324

Provider Business Practice Location Address
First Line	:	18170 DALLAS PKWY
Second Line	:	SUITE 502
City	:	DALLAS
State	:	TX
Zip	:	75287-7137
Country	:	US
Telephone Number	:	972-243-3343
Fax Number	:	972-243-7324

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	DR. JESSICA L. HUTTO
Credential	:	M.D.
Telephone Number	:	972-243-3343

Provider Enumeration Date	:	09/06/2016
Last Update Date	:	12/27/2016

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