Psych MD PLLC

Primary specialty

Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X

Legal business name

PSYCH MD PLLC

Practice address

4425 Plano Pkwy Ste 1401
Carrollton, TX 75010-5036

Phone

(214) 888-7711

NPI assigned

Nov 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Djillali Boudjenah, MDNPI 1083724256

Title

Ceo

Phone

(917) 336-8422

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Djillali Boudjenah, MD

  • Psychiatry Physician
  • Carrollton, TX
  • NPI 1083724256
  Medicare reassignment NPD Authorized official
• Rhoda Madamombe, MSN, APRN PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Allen, TX
  • NPI 1477131415
  Medicare reassignment NPD

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1609240977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 867443",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750867443",
            "telephone_number": "214-888-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 PLANO PKWY STE 1401",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750105036",
            "telephone_number": "214-888-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCH MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-24",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "BOUDJENAH",
        "authorized_official_first_name": "DJILLALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-336-8422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvette Proulx
• Todd B Prucha, R.PH.
• Julianne Joy Pruett, PA
• Prunty Chiropractic
• Tamikia Latray Prunty, DC
• Harjodh Singh Puar, M.D.
• Ravinder K Puar, MD
• Courtney Danyale Pullen, M.S., BCBA
• Pulmonary Associates of North Dallas, PA
• Pulmonary Care Specialists, P. a.

• Behavioral Neurology & Neuropsychiatry Physician in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Behavioral Neurology & Neuropsychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.