Organization
SENIOR PSYCHOLOGICAL CARE DALLAS I, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL J. FRAPART CPA (CHIEF FINANCIAL OFFICER)
(713) 850-0049
Entity
Organization
Contact information
Practice address
4635 SOUTHWEST FWY STE 635, HOUSTON, TX 77027-7112
(713) 850-0049
(713) 627-7302
Mailing address
4635 SOUTHWEST FWY STE 635, HOUSTON, TX 77027-7112
(713) 850-0049
(713) 627-7302
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012XB
BCBS TX
TX
05
—
287992601
—
TX
05
—
287992602
—
TX
05
—
287992603
—
TX
01
—
DS2658
RR MCR HARRIS
TX
Enumeration date
06/27/2011
Last updated
12/13/2018
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