Organization
BOOTHCOUNSEL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DAVID BOOTH L.P.C. (PROPRIETOR)
(972) 980-3919
Entity
Organization
Contact information
Practice address
15150 PRESTON RD STE 300, DALLAS, TX 75248-4871
(972) 980-3919
(972) 980-3921
Mailing address
15150 PRESTON RD STE 300, DALLAS, TX 75248-4871
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
18202
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008KM
BLUE CROSS PPO
TX
01
—
83746L
BLUE CHOICE
TX
Enumeration date
04/24/2007
Last updated
08/22/2020
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