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V.L.Y NEUROPSYCH GROUP P.A. NPI 1720380009


NPI Information

NPI: 1720380009
Provider Name: V.L.Y NEUROPSYCH GROUP P.A.
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

CLIA Number: 45D2106876

Address:
712 N WASHINGTON AVE
SUITE # 411
DALLAS, TX
ZIP 75246
Phone: (214) 824-9100
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V.L.Y NEUROPSYCH GROUP P.A. is a psychiatry psychiatry neurology in Dallas, TX. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. V.L.Y NEUROPSYCH GROUP P.A. NPI is 1720380009. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

712 N WASHINGTON AVE
SUITE # 411
DALLAS, TX
ZIP 75246-619
Phone: (214) 824-9100
Fax: (214) 824-9101

The provider's authorized official is Vladislav L. Yeganov .
The authorized official title is Owner and has the following contact phone number (214) 824-9100.

The CLIA number assigned to this NPI record is 45D2106876 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/19/2010 and was last updated on 12/2/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0800XPsychiatry & NeurologyPsychiatryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1610715MEDICARE PINTEXAS
2I08928OTHERUPIN
3166625701MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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