Provider Demographics
NPI:1164863189
Name:MEMORY CLINIC OF TEXAS
Entity Type:Organization
Organization Name:MEMORY CLINIC OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:214-691-5199
Mailing Address - Street 1:8330 MEADOW RD
Mailing Address - Street 2:SUITE 219
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3767
Mailing Address - Country:US
Mailing Address - Phone:214-691-5199
Mailing Address - Fax:214-890-7730
Practice Address - Street 1:8330 MEADOW RD
Practice Address - Street 2:SUITE 219
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3767
Practice Address - Country:US
Practice Address - Phone:214-691-5199
Practice Address - Fax:214-890-7730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-08
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23774103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty