Basic Information
Provider Information | |||||||||
NPI: | 1730284654 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | DOYEL MANAGEMENT, INC. | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | TEXAS BEHAVIORAL HEALTH | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 105 E PARK ROW DR | ||||||||
Address2: |   | ||||||||
City: | ARLINGTON | ||||||||
State: | TX | ||||||||
PostalCode: | 760104426 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8178041551 | ||||||||
FaxNumber: | 8172757866 | ||||||||
Practice Location | |||||||||
Address1: | 105 E PARK ROW DR | ||||||||
Address2: |   | ||||||||
City: | ARLINGTON | ||||||||
State: | TX | ||||||||
PostalCode: | 760104426 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8178041551 | ||||||||
FaxNumber: | 8172757866 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/14/2006 | ||||||||
LastUpdateDate: | 08/01/2008 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | DOYEL | ||||||||
AuthorizedOfficialFirstName: | LYNDA | ||||||||
AuthorizedOfficialMiddleName: | G | ||||||||
AuthorizedOfficialTitleorPosition: | OWNER/COUNSELOR | ||||||||
AuthorizedOfficialTelephone: | 8178041551 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | LMSW | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 17447 | TX | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor |   |
No ID Information.