Provider Demographics
NPI:1548896889
Name:B WELL PSYCHOLOGICAL SERVICES PLLC
Entity type:Organization
Organization Name:B WELL PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:REX-LEAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-845-8207
Mailing Address - Street 1:5105 TRAILS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-2047
Mailing Address - Country:US
Mailing Address - Phone:817-845-8207
Mailing Address - Fax:
Practice Address - Street 1:2301 OHIO DR STE 130
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3997
Practice Address - Country:US
Practice Address - Phone:972-612-1305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty