Provider Demographics
NPI:1639302052
Name:SCHEEN, JERRY S (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JERRY
Middle Name:S
Last Name:SCHEEN
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 N. WESTMORELAND RD
Mailing Address - Street 2:METROCARE CLINIC
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-0000
Mailing Address - Country:US
Mailing Address - Phone:214-330-0036
Mailing Address - Fax:214-337-3905
Practice Address - Street 1:1350 N WESTMORELAND RD
Practice Address - Street 2:METROCARE CLINIC
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1654
Practice Address - Country:US
Practice Address - Phone:214-330-0036
Practice Address - Fax:214-337-3905
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733577363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health