Organization
BEACON BEHAVIORAL OF TEXAS PA
Active
Parent organization
BEACON BEHAVIORAL OF TEXAS PA
Other names
The Grant Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEACON BEHAVIORAL OF TEXAS PA
Authorized official
KIMBERLY GLAVESKAS (CREDENTIALING SUPERVISOR)
(214) 550-7536
Entity
Organization
Contact information
Practice address
1604 HOSPITAL PKWY STE 507&508, BEDFORD, TX 76022-6986
(817) 354-7268
Mailing address
22 PRESTIGE CIR STE 200, ALLEN, TX 75002-3441
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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