Provider Demographics
NPI:1225173271
Name:PSYCHONE ASSOCIATES LLC
Entity Type:Organization
Organization Name:PSYCHONE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:972-680-1577
Mailing Address - Street 1:7708 MORNINGDEW DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3774
Mailing Address - Country:US
Mailing Address - Phone:972-680-1577
Mailing Address - Fax:
Practice Address - Street 1:7708 MORNINGDEW DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3774
Practice Address - Country:US
Practice Address - Phone:972-680-1577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00606YMedicare ID - Type Unspecified