Provider Demographics
NPI:1912258559
Name:AUTHENTIC INSIGHTS, INC.
Entity Type:Organization
Organization Name:AUTHENTIC INSIGHTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZY
Authorized Official - Middle Name:
Authorized Official - Last Name:GADOL ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-552-9958
Mailing Address - Street 1:17480 DALLAS PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7337
Mailing Address - Country:US
Mailing Address - Phone:214-552-9958
Mailing Address - Fax:
Practice Address - Street 1:17480 DALLAS PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7337
Practice Address - Country:US
Practice Address - Phone:214-552-9958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-23
Last Update Date:2012-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21376251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health