RESTORE BRAIN, PLLC (NPI# 1154839470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154839470 |
| Entity Type | Organization |
| Organization Name | RESTORE BRAIN, PLLC |
| Practice Address |
5207 Heritage Ave Colleyville TX 76034-5915 |
| Mailing Address |
4643 Westgrove Dr Addison TX 75001-3216 |
| Practice Telephone | 8889900663 |
| Practice Fax Number | 8889900663 |
| Mailing Telephone | 2145626364 |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | DAVID CICHY (PRACTICE BUSINESS MANAGER) |
| Authorized Official Telephone | 2145626364 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084B0040X |
Psychiatry & Neurology Specialization: Behavioral Neurology & Neuropsychiatry |
TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 17736 Preston Rd Ste 201, Dallas, TX 752525726 | 8889900663 | 8889900663 |
| Street Address |
5207 HERITAGE AVE |
| City | COLLEYVILLE |
| State | TX |
| Zip Code | 76034-5915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902855687 | Jeffrey M Bullard | Family Medicine | 5207 Heritage Ave, Ste105, Colleyville, TX 76034 | 2006-05-09 |
| 1629693544 | Maxfitness Health & Education | Clinic/Center | 5207 Heritage Ave, Colleyville, TX 76034-5915 | 2020-06-16 |
| 1578049359 | Maxhealth Medical Associates | Clinic/Center | 5207 Heritage Ave, Colleyville, TX 76034-5915 | 2018-07-16 |
| 1285110965 | Maxhealth Family, Internal & Sports Medicine | Family Medicine | 5207 Heritage Ave, Colleyville, TX 76034-5915 | 2018-07-16 |
| 1457887093 | Revolution Med Group, LLC | Clinical Neuropsychologist | 5207 Heritage Ave, Colleyville, TX 76034-5915 | 2017-05-02 |
| 1013440478 | Elevate Hc, Ll | Clinical Neuropsychologist | 5207 Heritage Ave, Colleyville, TX 76034-5915 | 2017-04-04 |
| 1801240809 | Ryan Austin Klitgaard | Family Medicine | 5207 Heritage Ave, Colleyville, TX 76034-5915 | 2016-04-16 |
| 1598148645 | Jmb Health Solutions LLC | Clinical Neuropsychologist | 5207 Heritage Ave, Colleyville, TX 76034 | 2015-07-08 |
| 1356694475 | Stephanie West | Physician Assistant | 5207 Heritage Ave, Colleyville, TX 76034-5915 | 2012-10-26 |
| 1487816914 | Allison Michael Phelps | Family Medicine | 5207 Heritage Ave, Colleyville, TX 76034 | 2008-06-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457967283 | Lumi Eye Care | Optometrist | 3855 Glade Road, Colleyville, TX 76034 | 2020-09-17 |
| 1528552718 | Dental Sc, Pllc | Dentist | 6700 Colleyville Blvd, Colleyville, TX 76034 | 2018-06-20 |
| 1447763503 | Pekam Takusi | Pharmacist | 704 Strauss, Colleyville, TX 76034 | 2017-11-13 |
| 1982128484 | Van Beljon LLC | Chiropractor | 1124 Glade Rd, Suite 140, Colleyville, TX 76034 | 2017-07-27 |
| 1871031120 | Gena Willams | Occupational Therapist | 4113 Gateway Dr #200, Colleyville, TX 76034 | 2017-02-07 |
| 1700255486 | Village Lane Apothecary | Pharmacy | 60 Village Ln, Suite 130, Colleyville, TX 76034 | 2015-09-23 |
| 1679968333 | Amber Robinson | Counselor | 5209 Heritage Ave #210, Colleyville, TX 76034 | 2015-03-31 |
| 1013305978 | Stat Sleep of Colleyville, LLP | Clinic/Center | 6407 Colleyville Blvd Ste B, Colleyville, TX 76034 | 2014-12-30 |
| 1528468717 | Colverse Iom LLC | Neurological Surgery | 1308 Somerset Ct, Colleyville, TX 76034 | 2014-08-26 |
| 1356752703 | Ideal Dental of Colleyville, Pllc | Dentist | 4712 Colleyville Blvd, Suite 110, Colleyville, TX 76034 | 2014-05-19 |
| Find all providers in zip 76034 | ||||
| Taxonomy Code | 2084B0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Behavioral Neurology & Neuropsychiatry |
| Behavioral Neurology & Neuropsychiatry is a medical subspecialty involving the diagnosis and treatment of neurologically based behavioral issues. |
| Notes: Source: National Uniform Claim Committee. [1/1/2012: new] Additional Resources: American Academy of Neurology, www.aan.com. |
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|---|---|---|---|---|
| 1033710892 | Anew Era Tms & Psychiatry of Texas, Pa | Psychiatry & Neurology | 7514 N Mopac Expressway, Suite 100, Austin, TX 78731 | 2020-11-06 |
| 1730688300 | Neuropsychiatric and Behavioral Consulting Pllc | Psychiatry & Neurology | 4888 Loop Central Dr Ste 510, Houston, TX 77081-2226 | 2018-02-08 |
| 1902241029 | Travis Noble Nance | Psychiatry & Neurology | 1 Criminal Justice Dr, Conroe, TX 77301-1491 | 2013-05-02 |
| 1215183512 | David Allan Williamson | Psychiatry & Neurology | 1 Riverway Ste 600, Houston, TX 77056-1993 | 2008-08-18 |
| 1356967574 | Regions Integrated Health & Wellness LLC | Psychiatry & Neurology | 1937 Texas Pkwy, Missouri City, TX 77489-3121 | 2020-06-23 |
| 1699241513 | Neuro Psychiatric & Behavioral Rehabilitation Practitioners Associatio | Psychiatry & Neurology | 2002 Holcombe Blvd, Houston, TX 77030-4211 | 2018-10-18 |
| 1467965905 | Hickory Trail Hospital, L.p. | Psychiatry & Neurology | 2000 Old Hickory Trl, Desoto, TX 75115-2242 | 2017-11-07 |
| 1861856114 | Symedic Pllc | Psychiatry & Neurology | 2245 Texas Dr, Suite 300, Sugar Land, TX 77479-1679 | 2016-04-12 |
| 1609240977 | Psych Md Pllc | Psychiatry & Neurology | 1029 Long Prairie Rd, Suite D, Flower Mound, TX 75022-4243 | 2015-11-24 |
| 1700265873 | Gonzalo A Aillon Md Pllc | Psychiatry & Neurology | 400 S Zang Blvd, Suite 802, Dallas, TX 75208-6643 | 2015-05-22 |
| Find all providers with the same taxonomy | ||||
| City | COLLEYVILLE |
| Zip Code | 76034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.