Organization
HEARTS FOUNDATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEATIX SIBYLLE WAGNER PYS.D. (EXECUTIVE DIRECTOR)
(310) 995-7427
Entity
Organization
Contact information
Practice address
6300 JOHN RYAN DR, FORT WORTH, TX 76132-4122
(310) 995-7427
Mailing address
6300 JOHN RYAN DR, FORT WORTH, TX 76132-4122
(310) 995-7427
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
36904
TX
251S00000X
Community/Behavioral Health Agency
PSY23746
CA
Other
Enumeration date
06/18/2014
Last updated
09/03/2015
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