Provider Demographics
NPI:1376124149
Name:TEXAS MHB
Entity Type:Organization
Organization Name:TEXAS MHB
Other - Org Name:TEXAS MHB
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LUTFC
Authorized Official - Phone:972-693-5245
Mailing Address - Street 1:1210 APRIL SHOWERS LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75134-4604
Mailing Address - Country:US
Mailing Address - Phone:197-269-3524
Mailing Address - Fax:
Practice Address - Street 1:1210 APRIL SHOWERS LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75134-4604
Practice Address - Country:US
Practice Address - Phone:972-693-5245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health