Organization Active NPI

Restore Brain, PLLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Denton, TX
National Provider Identifier
1154839470
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X
Legal business name
RESTORE BRAIN, PLLC
Practice address
2800 Shoreline Dr # 220
Denton, TX 76210-0128
Phone
(888) 990-0663
Fax
(888) 990-0663
NPI assigned
Jan 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
David Cichy
Title
Practice Manager
Phone
(214) 562-6364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084B0040X TX Primary

Addresses

Primary practice location

2800 Shoreline Dr # 220
Denton, TX 76210-0128

Mailing address

4643 Westgrove Dr
Addison, TX 75001-3216
Phone (214) 562-6364

Other practice location 1

11477 Olde Cabin Rd Ste 210
Saint Louis, MO 63141-7129
Phone (888) 990-0663

Other practice location 2

1005 W Ralph Hall Pkwy Ste 201
Rockwall, TX 75032-6662
Phone (888) 990-0663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190510001036 TX Part B Supplier - Clinic/Group Practice 7517200769 Receives reassigned benefits from 3 practitioners
Practice locations: Denton, TX; Rockwall, TX; Colleyville, TX
O20250319001677 MO Part B Supplier - Clinic/Group Practice 7517200769 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory
Tax ID family
Restore Brain PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4643 Westgrove Dr
Addison, TX 75001
Phone (214) 562-6364

5207 Heritage Ave
Colleyville, TX 76034
Phone (817) 355-8000

2721 Shoreline Dr
#120
Denton, TX 76210
Phone (888) 990-0663

2800 Shoreline Dr
Ste 220
Denton, TX 76210
Phone (888) 990-0663

2800 Shoreline Dr
#220
Denton, TX 76210
Phone (888) 990-0663

2711 Shoreline Dr
#220
Denton, TX 76210

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1154839470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4643 WESTGROVE DR",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013216",
            "telephone_number": "214-562-6364",
            "fax_number": "888-990-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 SHORELINE DR # 220",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762100128",
            "telephone_number": "888-990-0663",
            "fax_number": "888-990-0663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11477 Olde Cabin Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631417129",
            "country_code": "US",
            "telephone_number": "888-990-0663",
            "fax_number": "888-990-0663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1005 W Ralph Hall Pkwy Ste 201",
            "address_purpose": "LOCATION",
            "city": "Rockwall",
            "state": "TX",
            "postal_code": "750326662",
            "country_code": "US",
            "telephone_number": "888-990-0663",
            "fax_number": "888-990-0663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESTORE BRAIN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "CICHY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "214-562-6364"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.