Basic Information
| Provider Information | |||||||||
| NPI: | 1083169650 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BASKINS MCCOY | ||||||||
| FirstName: | ZAUNDRA | ||||||||
| MiddleName: | K | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7901 BONITO DR | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760024118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6822155171 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6100 WESTERN PL STE 408 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761074690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177354165 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2016 | ||||||||
| LastUpdateDate: | 08/23/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | DIAGNOSTICIAN | TX | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.