Provider Demographics
NPI:1215201876
Name:DALLAS CBT PLLC
Entity Type:Organization
Organization Name:DALLAS CBT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASPER
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-768-4125
Mailing Address - Street 1:5904 JUNIUS ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-4428
Mailing Address - Country:US
Mailing Address - Phone:214-768-4125
Mailing Address - Fax:
Practice Address - Street 1:7557 RAMBLER RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4142
Practice Address - Country:US
Practice Address - Phone:214-476-6176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33238103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty