Provider Demographics
NPI:1336855113
Name:MINDS OF GOLD
Entity Type:Organization
Organization Name:MINDS OF GOLD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFLORA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:972-292-0533
Mailing Address - Street 1:709 CHERRY BLOSSOM ST
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-5006
Mailing Address - Country:US
Mailing Address - Phone:972-292-0533
Mailing Address - Fax:
Practice Address - Street 1:4645 WYNDHAM LN STE 240
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-0025
Practice Address - Country:US
Practice Address - Phone:972-292-0533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA114569167OtherPROVIDER NPI #