Organization
AT4K TEXAS PROVIDERS PLLC
Active
Organization
AT4K TEXAS PROVIDERS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS TILLOTSON (CEO)
(248) 770-9929
Entity
Organization
Contact information
Practice address
1100 S MAIN ST STE 103, GRAPEVINE, TX 76051-7531
(817) 310-5510
Mailing address
112 WALNUT BLVD UNIT 308, ROCHESTER, MI 48307-2317
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
Other
Enumeration date
01/08/2025
Last updated
02/07/2025
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