Provider Demographics
NPI:1790438497
Name:OMER, DEJIN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DEJIN
Middle Name:
Last Name:OMER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 WHITE HILLS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-5527
Mailing Address - Country:US
Mailing Address - Phone:972-772-3630
Mailing Address - Fax:
Practice Address - Street 1:601 WHITE HILLS DR STE 100
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5527
Practice Address - Country:US
Practice Address - Phone:972-772-3630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX861951163W00000X
TX11734002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No163W00000XNursing Service ProvidersRegistered Nurse