Provider Demographics
NPI:1558112219
Name:A & J PSYCHIATRY AND WELLNESS PLLC
Entity Type:Organization
Organization Name:A & J PSYCHIATRY AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ADEWUNMI
Authorized Official - Middle Name:JULIUS
Authorized Official - Last Name:BANKOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:214-997-0426
Mailing Address - Street 1:2000 E LAMAR BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-7361
Mailing Address - Country:US
Mailing Address - Phone:214-997-0426
Mailing Address - Fax:
Practice Address - Street 1:2000 E LAMAR BLVD STE 600
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-7361
Practice Address - Country:US
Practice Address - Phone:214-997-0426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty