| Beacon Mental And Wellness Center Limited Liability Company | |
|
1534 N Hampton Rd Bldg C Desoto TX 75115-2302 | |
| (817) 366-0950 | |
| Not Available |
| Full Name | Beacon Mental And Wellness Center Limited Liability Company |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1534 N Hampton Rd Bldg C, Desoto, Texas |
| Authorized Official Name and Position | Patrick Moneke (CEO) |
| Authorized Official Contact | 8173660950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Mental And Wellness Center Limited Liability Company 1534 N Hampton Rd Bldg C Desoto TX 75115-2302 Ph: (817) 366-0950 | Beacon Mental And Wellness Center Limited Liability Company 1534 N Hampton Rd Bldg C Desoto TX 75115-2302 Ph: (817) 366-0950 |
| NPI Number | 1336983709 |
|---|---|
| Provider Enumeration Date | 06/20/2024 |
| Last Update Date | 05/22/2025 |
| Medicare PECOS PAC ID | 2163942731 |
|---|---|
| Medicare Enrollment ID | O20250226001400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336983709 | NPI | - | NPPES |
| Provider Name | Muhammad Haqqani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942253372 PECOS PAC ID: 7416936802 Enrollment ID: I20040719000966 |
| Provider Name | Siminibe P Moneke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861902934 PECOS PAC ID: 0446526297 Enrollment ID: I20171023000210 |
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