Provider Demographics
NPI:1104445220
Name:NEOGEN MENTAL HEALTH AND BEHAVIORAL SERVICES, PA.
Entity type:Organization
Organization Name:NEOGEN MENTAL HEALTH AND BEHAVIORAL SERVICES, PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:H
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:469-955-5223
Mailing Address - Street 1:2141 KIRKWOOD BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-1464
Mailing Address - Country:US
Mailing Address - Phone:469-955-5223
Mailing Address - Fax:817-251-8844
Practice Address - Street 1:2141 KIRKWOOD BLVD STE 130
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-1464
Practice Address - Country:US
Practice Address - Phone:469-955-5223
Practice Address - Fax:817-251-8844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty