| Preston Hollow Psychiatry Group, Pllc | |
|
16479 Dallas Pkwy Ste 320 Addison TX 75001-6709 | |
| (214) 697-8230 | |
| (469) 484-4260 |
| Full Name | Preston Hollow Psychiatry Group, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 16479 Dallas Pkwy Ste 320, Addison, Texas |
| Authorized Official Name and Position | Marty Neal Bennett (MANAGER) |
| Authorized Official Contact | 2146978230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Preston Hollow Psychiatry Group, Pllc 16479 Dallas Pkwy Ste 320 Addison TX 75001-6709 Ph: (214) 697-8230 | Preston Hollow Psychiatry Group, Pllc 16479 Dallas Pkwy Ste 320 Addison TX 75001-6709 Ph: (214) 697-8230 |
| NPI Number | 1851583397 |
|---|---|
| Provider Enumeration Date | 08/17/2007 |
| Last Update Date | 04/13/2021 |
| Certification Date | 04/13/2021 |
| Medicare PECOS PAC ID | 7618385337 |
|---|---|
| Medicare Enrollment ID | O20210419002315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851583397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | L0029 (Texas) | Primary |
| Provider Name | Marty N Bennett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487616272 PECOS PAC ID: 4385810308 Enrollment ID: I20111221000788 |
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