Basic Information
| Provider Information | |||||||||
| NPI: | 1720417462 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEGAL | ||||||||
| FirstName: | JOSEE | ||||||||
| MiddleName: | |||||||||
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| Credential: | PMHNP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | PAQUETTE | ||||||||
| OtherFirstName: | JOSEE | ||||||||
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| OtherCredential: | PMHNP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3600 SAINT MARK DR | ||||||||
| Address2: | |||||||||
| City: | FLOWER MOUND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750227865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9723555888 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2620 LONG PRAIRIE RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | FLOWER MOUND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750224953 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722217900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2013 | ||||||||
| LastUpdateDate: | 05/27/2016 | ||||||||
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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 | 363LP0808X | 824358 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.