Provider Demographics
NPI:1457705469
Name:A WISER MIND TEXAS LLC
Entity Type:Organization
Organization Name:A WISER MIND TEXAS LLC
Other - Org Name:A WISER MIND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-940-8531
Mailing Address - Street 1:6000 E EVANS AVE
Mailing Address - Street 2:3-100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5406
Mailing Address - Country:US
Mailing Address - Phone:720-940-8531
Mailing Address - Fax:720-378-5034
Practice Address - Street 1:11816 INWOOD RD
Practice Address - Street 2:STE 161
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-8011
Practice Address - Country:US
Practice Address - Phone:972-848-3684
Practice Address - Fax:720-378-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty