Jeannie Daw, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

JEANNIE DAW, PLLC

Doing business as

Saul Martinez

Practice address

6040 Camp Bowie Blvd Ste 56
Fort Worth, TX 76116-5601

Phone

(817) 841-9406

NPI assigned

Jan 18, 2022

Last updated

Jan 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeannie Daw

Title

Owner

Phone

(817) 841-9406

Specialties & licenses 3

Addresses

Other names 1

• Saul Martinez Doing business as

Locations

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1487306742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 CAMP BOWIE BLVD STE 56",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 CAMP BOWIE BLVD STE 56",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165601",
            "telephone_number": "817-841-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANNIE DAW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "DAW",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-841-9406"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saul Martinez",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.