Provider Demographics
NPI:1134609282
Name:ELEVATE HC TEXAS PLLC
Entity type:Organization
Organization Name:ELEVATE HC TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRIMPF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-355-8000
Mailing Address - Street 1:712 N WASHINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1632
Mailing Address - Country:US
Mailing Address - Phone:855-435-3828
Mailing Address - Fax:
Practice Address - Street 1:712 N WASHINGTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246
Practice Address - Country:US
Practice Address - Phone:855-435-3828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty