Provider Demographics
NPI:1164173266
Name:BRAINWELL PSYCHIATRY AND MENTAL HEALTH PLLC
Entity Type:Organization
Organization Name:BRAINWELL PSYCHIATRY AND MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-360-8488
Mailing Address - Street 1:PO BOX 1200
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-1200
Mailing Address - Country:US
Mailing Address - Phone:512-360-8488
Mailing Address - Fax:956-253-2505
Practice Address - Street 1:909 PECAN ST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-3819
Practice Address - Country:US
Practice Address - Phone:512-360-8488
Practice Address - Fax:956-253-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty