Provider Demographics
NPI:1063233575
Name:GEM PSYCHIATRY
Entity type:Organization
Organization Name:GEM PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-423-9157
Mailing Address - Street 1:3001 S HARDIN BLVD
Mailing Address - Street 2:STE 110 #103
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7702
Mailing Address - Country:US
Mailing Address - Phone:469-423-9157
Mailing Address - Fax:
Practice Address - Street 1:225 GILPIN LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5171
Practice Address - Country:US
Practice Address - Phone:469-423-9157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)