| Creative Minds Tx Llc | |
|
7441 Marvin D Love Fwy Dallas TX 75237-3490 | |
| (469) 491-4911 | |
| Not Available |
| Full Name | Creative Minds Tx Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7441 Marvin D Love Fwy, Dallas, Texas |
| Authorized Official Name and Position | Jazzamin Clark (OWNER) |
| Authorized Official Contact | 7023541794 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Minds Tx Llc 7441 Marvin D Love Fwy Dallas TX 75237-3490 Ph: (469) 491-4911 | Creative Minds Tx Llc 7441 Marvin D Love Fwy Dallas TX 75237-3490 Ph: (469) 491-4911 |
| NPI Number | 1861253841 |
|---|---|
| Provider Enumeration Date | 01/17/2024 |
| Last Update Date | 11/18/2024 |
| Certification Date | 11/18/2024 |
| Medicare PECOS PAC ID | 4789125667 |
|---|---|
| Medicare Enrollment ID | O20240918003877 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861253841 | NPI | - | NPPES |
| Provider Name | Peter N Njogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437862257 PECOS PAC ID: 7517310113 Enrollment ID: I20240918004026 |
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