Provider Demographics
NPI:1164227948
Name:RESTORATION PSYCHIATRY PLLC
Entity type:Organization
Organization Name:RESTORATION PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-537-2909
Mailing Address - Street 1:2929 N CENTRAL EXPY STE 235
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2047
Mailing Address - Country:US
Mailing Address - Phone:142-785-5547
Mailing Address - Fax:214-329-0553
Practice Address - Street 1:2929 N CENTRAL EXPY STE 235
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2047
Practice Address - Country:US
Practice Address - Phone:142-785-5547
Practice Address - Fax:214-329-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528777927OtherNPI
1124370390OtherNPI