Organization
SENIOR PSYCHCARE OF DALLAS I, PLLC
Active
Parent organization
PSYCHIATRIC SERVICES, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PSYCHIATRIC SERVICES, PLLC
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
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0095WY
BCBS TX
TX
05
—
288003101
—
TX
05
—
288003102
—
TX
05
—
288003103
—
TX
05
—
288003104
—
TX
01
—
DS2656
RR MCR HARRIS
TX
Enumeration date
06/28/2011
Last updated
12/13/2018
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