Provider Demographics
NPI:1912590209
Name:AMEN CLINICS INC, DALLAS
Entity Type:Organization
Organization Name:AMEN CLINICS INC, DALLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE TRAINER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:703-880-4000
Mailing Address - Street 1:7301 STATE HIGHWAY 161 STE 170
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2812
Mailing Address - Country:US
Mailing Address - Phone:214-483-7070
Mailing Address - Fax:
Practice Address - Street 1:7301 STATE HIGHWAY 161 STE 170
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2812
Practice Address - Country:US
Practice Address - Phone:214-483-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMEN CLINICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic NeuroimagingGroup - Multi-Specialty