Provider Demographics
NPI:1992164115
Name:OCD AND ANXIETY SPECIALISTS OF DALLAS,INC.
Entity type:Organization
Organization Name:OCD AND ANXIETY SPECIALISTS OF DALLAS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:EVONNE
Authorized Official - Last Name:ROCKWELL-EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-368-6999
Mailing Address - Street 1:375 MUNICIPAL DR STE 230
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3624
Mailing Address - Country:US
Mailing Address - Phone:214-368-6999
Mailing Address - Fax:972-643-9394
Practice Address - Street 1:375 MUNICIPAL DR SUITE 230
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:214-368-6999
Practice Address - Fax:972-643-9394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC 8758261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health