Idera Behavioral Health PLLC

Primary specialty

Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X

Legal business name

IDERA BEHAVIORAL HEALTH PLLC

Practice address

3036 Larreta
Grand Prairie, TX 75054-6794

Phone

(817) 217-0662

NPI assigned

Oct 15, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Babatunde Shittu, PMHNP-BCNPI 1497385645

Title

Nurse Practitioner

Phone

(817) 217-0662

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Babatunde T Shittu, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Prairie, TX
  • NPI 1497385645
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1053287045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3036 LARRETA",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750546794",
            "telephone_number": "817-217-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3036 LARRETA",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750546794",
            "telephone_number": "817-217-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDERA BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "SHITTU",
        "authorized_official_first_name": "BABATUNDE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "817-217-0662",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavioral Neurology & Neuropsychiatry Physician in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Behavioral Neurology & Neuropsychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.