1962123653 NPI number — TOPMIND PSYCHIATRIC MENTAL HEALTH & BEHAVIORAL SERVICES PLLC

Table of content: (NPI 1962123653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962123653 NPI number — TOPMIND PSYCHIATRIC MENTAL HEALTH & BEHAVIORAL SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOPMIND PSYCHIATRIC MENTAL HEALTH & BEHAVIORAL SERVICES 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:
Provider Other Organization Name Type Code:
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:
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NPI Number Information

NPI Number:
1962123653
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
811 W JEFFERSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND PRAIRIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75051-1645
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
682-358-1861
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
811 W JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND PRAIRIE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75051-1645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
682-358-1861
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ADEYOMOLA
Authorized Official First Name:
TOPE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER OF ENTITY
Authorized Official Telephone Number:
214-676-6042

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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