Provider Demographics
NPI:1568923365
Name:DALLAS THERAPY ALLIANCE
Entity Type:Organization
Organization Name:DALLAS THERAPY ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ENANDER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-736-4352
Mailing Address - Street 1:12801 N CENTRAL EXPY STE 1730
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1872
Mailing Address - Country:US
Mailing Address - Phone:214-736-4352
Mailing Address - Fax:
Practice Address - Street 1:12801 N CENTRAL EXPY STE 1730
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1872
Practice Address - Country:US
Practice Address - Phone:214-736-4352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty