Organization
LAKESIDE SERENITY PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALLAS UPCHURCH PMHNP-BC (OWNER)
(917) 265-9614
Entity
Organization
Contact information
Practice address
5441 S.MACCADAN AVE 8160, PORTLAND, OR 97239
(917) 265-9614
Mailing address
821 KENDRA DR, TEMPLE, TX 76502-5878
(917) 265-9611
(917) 265-9614
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/30/2025
Last updated
12/30/2025
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