Provider Demographics
NPI:1912463019
Name:VALLEY RANCH PSYCHIATRY
Entity Type:Organization
Organization Name:VALLEY RANCH PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:F
Authorized Official - Last Name:YODERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-601-1818
Mailing Address - Street 1:20130 ALEXANDER LN
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-3302
Mailing Address - Country:US
Mailing Address - Phone:281-851-8261
Mailing Address - Fax:281-429-3657
Practice Address - Street 1:22118 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357
Practice Address - Country:US
Practice Address - Phone:281-601-1808
Practice Address - Fax:281-429-3657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)