Provider Demographics
NPI:1497461578
Name:TEXAS PSYCHIATRIC MEDICINE PLLC
Entity Type:Organization
Organization Name:TEXAS PSYCHIATRIC MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENCHCLIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-584-5180
Mailing Address - Street 1:2201 CIVIC CIR STE 919
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1817
Mailing Address - Country:US
Mailing Address - Phone:806-584-5180
Mailing Address - Fax:
Practice Address - Street 1:2201 CIVIC CIR STE 919
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1817
Practice Address - Country:US
Practice Address - Phone:806-584-5180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty