Organization
PHOENIX HOUSES OF TEXAS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BART R LOEWEN (PRESIDENT & CEO)
(214) 920-1628
Entity
Organization
Contact information
Practice address
2345 REAGAN ST, DALLAS, TX 75219-3225
(214) 999-1044
(214) 526-3285
Mailing address
1910 PACIFIC AVE STE 10500, DALLAS, TX 75201-4591
(214) 920-1628
(214) 351-0967
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
865
TX
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065459201
—
TX
05
—
170251601
—
TX
05
—
319371601
—
TX
05
—
335999401
—
TX
01
—
865-865M
STATE OF TEXAS
—
01
—
865-865P
STATE OF TEXAS
—
Enumeration date
02/26/2007
Last updated
12/20/2022
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