Organization Active NPI

Ryezin Psychiatry & Healthcare Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Burleson, TX
National Provider Identifier
1093516916
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
RYEZIN PSYCHIATRY & HEALTHCARE SERVICES LLC
Practice address
295 E Renfro St Ste 300
Burleson, TX 76028-3954
Phone
(817) 415-2250
Fax
(817) 415-2282
NPI assigned
Mar 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Jackquelyn WilliamsNPI 1306249602
Title
Owner of Entity
Phone
(817) 415-2250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

295 E Renfro St Ste 300
Burleson, TX 76028-3954

Mailing address

295 E Renfro St Ste 300
Burleson, TX 76028-3954
Phone (817) 415-2250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250425000106 TX Part B Supplier - Clinic/Group Practice 0143746834 Receives reassigned benefits from 1 practitioner
Practice locations: Burleson, TX

National Provider Directory

National Provider Directory

Locations

295 E Renfro St
Ste 300
Burleson, TX 76028
Phone (817) 415-2250

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1093516916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 E RENFRO ST STE 300",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760283954",
            "telephone_number": "817-415-2250",
            "fax_number": "817-415-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 E RENFRO ST STE 300",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760283954",
            "telephone_number": "817-415-2250",
            "fax_number": "817-415-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYEZIN PSYCHIATRY & HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JACKQUELYN",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "817-415-2250"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.