Provider Demographics
NPI:1730885179
Name:TONIMAK PSYCHIATRY PLLC
Entity type:Organization
Organization Name:TONIMAK PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTHONIA
Authorized Official - Middle Name:ONYINYE
Authorized Official - Last Name:OYERINDE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:682-433-3928
Mailing Address - Street 1:808 DALWORTH ST STE A-122
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-5542
Mailing Address - Country:US
Mailing Address - Phone:682-433-3928
Mailing Address - Fax:
Practice Address - Street 1:808 DALWORTH ST STE A-122
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5542
Practice Address - Country:US
Practice Address - Phone:682-433-3928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty