Organization
IDERA BEHAVIORAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BABATUNDE SHITTU PMHNP-BC (NURSE PRACTITIONER)
(817) 217-0662
Entity
Organization
Contact information
Practice address
3036 LARRETA, GRAND PRAIRIE, TX 75054-6794
(817) 217-0662
Mailing address
3036 LARRETA, GRAND PRAIRIE, TX 75054-6794
(817) 217-0662
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
—
—
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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