Provider Demographics
NPI:1437938115
Name:EMH MID-CITIES PLLC
Entity type:Organization
Organization Name:EMH MID-CITIES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:817-682-1600
Mailing Address - Street 1:748 RICHMOND LN
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-5244
Mailing Address - Country:US
Mailing Address - Phone:817-682-1600
Mailing Address - Fax:
Practice Address - Street 1:4841 MERLOT AVE
Practice Address - Street 2:STE 420
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7382
Practice Address - Country:US
Practice Address - Phone:817-809-8399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMH MID-CITIES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty