Provider Demographics
NPI:1881320620
Name:MYNDCARE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:MYNDCARE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:UCHECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:UKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-961-0055
Mailing Address - Street 1:1675 REPUBLIC PKWY
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6903
Mailing Address - Country:US
Mailing Address - Phone:469-961-0055
Mailing Address - Fax:
Practice Address - Street 1:1675 REPUBLIC PKWY
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6903
Practice Address - Country:US
Practice Address - Phone:469-961-0055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty