Provider Demographics
NPI:1558304691
Name:TURNBULL, DANA BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:BETH
Last Name:TURNBULL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12701 BEECH TREE LN
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3427
Mailing Address - Country:US
Mailing Address - Phone:817-571-2899
Mailing Address - Fax:817-571-9879
Practice Address - Street 1:305 MIRON DR
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7831
Practice Address - Country:US
Practice Address - Phone:817-571-2899
Practice Address - Fax:817-571-9879
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31454103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00478YOtherMEDICARE PTAN
TX0417750-04Medicaid
TX00478YOtherMEDICARE PTAN