Organization
TEXARKANA PSYCHIATRIC SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JODY A BARHAM APN (OWNER/APN)
(870) 773-1711
Entity
Organization
Contact information
Practice address
2116 N STATE LINE AVE, TEXARKANA, AR 71854-3583
(870) 773-1711
(870) 773-1712
Mailing address
2116 N STATE LINE AVE, TEXARKANA, AR 71854-3583
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992081491
INDIVIDUAL NPI
—
Enumeration date
08/14/2019
Last updated
08/14/2019
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