Provider Demographics
NPI:1477277192
Name:EMH MID-CITIES PLLC
Entity type:Organization
Organization Name:EMH MID-CITIES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACIELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:817-682-1600
Mailing Address - Street 1:748 RICHMOND LN
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-5244
Mailing Address - Country:US
Mailing Address - Phone:817-682-1600
Mailing Address - Fax:817-918-7307
Practice Address - Street 1:8408 DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8685
Practice Address - Country:US
Practice Address - Phone:682-382-1329
Practice Address - Fax:817-918-7307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-27
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty