TP Innovation Psychiatry

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

TP INNOVATION PSYCHIATRY

Practice address

3447 Renner Rd Ste 120
Plano, TX 75074-0051

Phone

(972) 876-0387

NPI assigned

Oct 2, 2023

Organization subpart

No

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

Authorized official

Name

Thanh Phan, APRNNPI 1083377568

Title

Owner

Phone

(972) 876-0387

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 3

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

• Thanh Phan, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Plano, TX
  • NPI 1083377568
  Medicare reassignment NPD Authorized official
• Pavan Kumar Reddy Pamadurthi, M.D.

  • Psychiatry Physician
  • Temple, TX
  • NPI 1982835112
  NPD
• Jamie Lynn Hulm, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Richardson, TX
  • NPI 1013475813

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1124808829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3447 RENNER RD STE 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750740051",
            "telephone_number": "972-876-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3447 RENNER RD STE 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750740051",
            "telephone_number": "972-876-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TP INNOVATION PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "THANH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-876-0387",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Christine Tovar
• Tracy Dawn Towles, FNP-C
• Taja Towne, LCSW
• Henry Bernard Townsend, M.D.
• Sean Allan Townsend, M.D.
• Traci Koen, LPC-S, PLLC
• Traci L. Nivens, M.D., P.a.
• Tracy C. Woehl Crna, P.C.
• Tradeway International LLC
• Tradewind Management LLC

• Psychiatric/Mental Health Nurse Practitioner in Plano, TX
• Providers in Plano, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.