Provider Demographics
NPI:1750551867
Name:WELLSPRING PSYCHOLOGICAL ASSOCIATES, P.L.L.C.WELLSPRING PSYCHO
Entity type:Organization
Organization Name:WELLSPRING PSYCHOLOGICAL ASSOCIATES, P.L.L.C.WELLSPRING PSYCHO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:FEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:832-448-2800
Mailing Address - Street 1:12012 WICKCHESTER LN
Mailing Address - Street 2:SUITE 550
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1229
Mailing Address - Country:US
Mailing Address - Phone:832-448-2830
Mailing Address - Fax:832-448-2801
Practice Address - Street 1:658 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1805
Practice Address - Country:US
Practice Address - Phone:832-448-2830
Practice Address - Fax:832-448-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0033QUOtherBCBS
TXDG5459OtherRAILROAD MEDICARE