Provider Demographics
NPI:1487183406
Name:PRESTON HOLLOW HEALTH & WELLNESS, PLLC
Entity Type:Organization
Organization Name:PRESTON HOLLOW HEALTH & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-863-2232
Mailing Address - Street 1:8140 WALNUT HILL LN STE 320
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4328
Mailing Address - Country:US
Mailing Address - Phone:972-773-9027
Mailing Address - Fax:972-474-9043
Practice Address - Street 1:8140 WALNUT HILL LN STE 320
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4328
Practice Address - Country:US
Practice Address - Phone:972-773-9027
Practice Address - Fax:972-474-9043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36341103T00000X, 103TC1900X
TX37647103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty