Provider Demographics
NPI:1699369991
Name:AT & TC CONSULTATION SERVICES, PLLC
Entity Type:Organization
Organization Name:AT & TC CONSULTATION SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR/ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:ALTHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-281-2448
Mailing Address - Street 1:410 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-4533
Mailing Address - Country:US
Mailing Address - Phone:318-281-2448
Mailing Address - Fax:318-281-5445
Practice Address - Street 1:4673 EUGENE WARE BLVD
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-1425
Practice Address - Country:US
Practice Address - Phone:318-281-2448
Practice Address - Fax:318-281-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty