1598450694 NPI number — ADAPTIVE PSYCHIATRIC SOLUTIONS PLLC

Table of content: (NPI 1598450694)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598450694 NPI number — ADAPTIVE PSYCHIATRIC SOLUTIONS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAPTIVE PSYCHIATRIC SOLUTIONS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
A BETTER OUTLOOK PSYCHIATRY AND ADDICTION
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598450694
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1009 E INTERSTATE 30 STE 1074
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKWALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75087-4826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-206-5207
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 TRAVIS RANCH BLVD
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
FORNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-910-5902
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2023

Additional Information

Authorized Official

Authorized Official Last Name:
DUKE
Authorized Official First Name:
MICAH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/MANAGER
Authorized Official Telephone Number:
940-206-5207

Provider Taxonomy Codes

  • Taxonomy code: 2084A0401X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0802X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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