Provider Demographics
NPI:1457136582
Name:SERENITY PSYCHIATRY OF NORTH TEXAS, PLLC
Entity Type:Organization
Organization Name:SERENITY PSYCHIATRY OF NORTH TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:COLLEEN
Authorized Official - Last Name:WILLBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:817-646-9699
Mailing Address - Street 1:6777 CAMP BOWIE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-7156
Mailing Address - Country:US
Mailing Address - Phone:817-646-9699
Mailing Address - Fax:817-259-2841
Practice Address - Street 1:6777 CAMP BOWIE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7156
Practice Address - Country:US
Practice Address - Phone:817-646-9699
Practice Address - Fax:817-259-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty