Provider Demographics
NPI:1760008171
Name:OUTPATIENT PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:OUTPATIENT PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGDALENE
Authorized Official - Middle Name:E
Authorized Official - Last Name:OSUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:972-293-9795
Mailing Address - Street 1:1269 LONGLEAF DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5457
Mailing Address - Country:US
Mailing Address - Phone:972-293-9795
Mailing Address - Fax:866-497-1972
Practice Address - Street 1:1269 LONGLEAF DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-5457
Practice Address - Country:US
Practice Address - Phone:214-476-3770
Practice Address - Fax:866-497-1972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty