Provider Demographics
NPI:1144958802
Name:NCC ENDEAVOR PLLC
Entity type:Organization
Organization Name:NCC ENDEAVOR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-688-3386
Mailing Address - Street 1:4200 COUNTRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-8500
Mailing Address - Country:US
Mailing Address - Phone:817-688-3386
Mailing Address - Fax:
Practice Address - Street 1:3901 W GREEN OAKS BLVD STE B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-2789
Practice Address - Country:US
Practice Address - Phone:682-532-9600
Practice Address - Fax:817-668-0527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty