NPIMap

Organization Active NPI

Neogen Mental Health and Behavioral Services, PA.

  • Psychiatry Physician
  • Southlake, TX
National Provider Identifier
1104445220
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NEOGEN MENTAL HEALTH AND BEHAVIORAL SERVICES, PA.
Practice address
2141 Kirkwood Blvd Ste 130
Southlake, TX 76092-1464
Phone
(469) 955-5223
Fax
(817) 251-8844
NPI assigned
Apr 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Authorized official

Name
Dr. Eugene H Fletcher, DONPI 1548231806
Title
Psychiatrist
Phone
(469) 955-5223

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2141 Kirkwood Blvd Ste 130
Southlake, TX 76092-1464

Mailing address

2141 Kirkwood Blvd Ste 130
Southlake, TX 76092-1464
Phone (469) 955-5223

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address efletcher@NEOGEN-TX.direct.office.nextgen.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241024002118 TX Part B Supplier - Clinic/Group Practice 5991238362 Receives reassigned benefits from 1 practitioner
Practice locations: Southlake, TX

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: efletcher@neogen-tx.direct.office.nextgen.com

Practitioners & affiliated clinicians

Practitioners 3

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": "1586390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1104445220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 KIRKWOOD BLVD STE 130",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921464",
            "telephone_number": "469-955-5223",
            "fax_number": "817-251-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 KIRKWOOD BLVD STE 130",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921464",
            "telephone_number": "469-955-5223",
            "fax_number": "817-251-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOGEN MENTAL HEALTH AND BEHAVIORAL SERVICES, PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "469-955-5223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "efletcher@NEOGEN-TX.direct.office.nextgen.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2141 Kirkwood Blvd Ste 130",
            "city": "Southlake",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760921464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.