Provider Demographics
NPI:1366203283
Name:R.B PSYCHIATRIC HEALTH SERVICES, PLLC
Entity type:Organization
Organization Name:R.B PSYCHIATRIC HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:LAURENTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:UWAMAHORO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:817-865-5365
Mailing Address - Street 1:698 GRAPEVINE HWY # 155
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2815
Mailing Address - Country:US
Mailing Address - Phone:817-865-5365
Mailing Address - Fax:817-865-5372
Practice Address - Street 1:1814 8TH AVE STE B7
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-1354
Practice Address - Country:US
Practice Address - Phone:817-865-5365
Practice Address - Fax:817-865-5372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty