Provider Demographics
NPI:1760522692
Name:PITTS, LINDA JANE (EDD, PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JANE
Last Name:PITTS
Suffix:
Gender:F
Credentials:EDD, PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2591 DALLAS PARKWAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:972-377-0039
Mailing Address - Fax:972-377-0004
Practice Address - Street 1:2591 DALLAS PARKWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:972-377-0039
Practice Address - Fax:972-377-0004
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32950103TH0100X
TN1923103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3688449Medicare ID - Type Unspecified
TX612827Medicare PIN