Provider Demographics
NPI:1124857750
Name:MAINSTREAM PSYCHIATRY ASSOCIATES PLLC
Entity type:Organization
Organization Name:MAINSTREAM PSYCHIATRY ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ORAFUNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-220-3534
Mailing Address - Street 1:2603 BAXTER DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7081
Mailing Address - Country:US
Mailing Address - Phone:346-220-3534
Mailing Address - Fax:
Practice Address - Street 1:2100 N STATE HIGHWAY 360
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-1011
Practice Address - Country:US
Practice Address - Phone:346-220-3534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty