Provider Demographics
NPI:1942014972
Name:TUMAINI PSYCHIATRY PLLC
Entity type:Organization
Organization Name:TUMAINI PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:SYOMBUA
Authorized Official - Last Name:JEDIDAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-593-0477
Mailing Address - Street 1:539 W COMMERCE ST # 3213
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-1953
Mailing Address - Country:US
Mailing Address - Phone:682-593-0477
Mailing Address - Fax:682-593-0447
Practice Address - Street 1:2300 VALLEY VIEW LN
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-1721
Practice Address - Country:US
Practice Address - Phone:682-593-0477
Practice Address - Fax:682-593-0447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty