Provider Demographics
NPI:1679609093
Name:PITTMAN, JULIE ROSS (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ROSS
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:DANIELLE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:3602 MATLOCK RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3600
Mailing Address - Country:US
Mailing Address - Phone:817-472-9369
Mailing Address - Fax:817-472-9361
Practice Address - Street 1:3602 MATLOCK RD STE 210
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3600
Practice Address - Country:US
Practice Address - Phone:817-472-9369
Practice Address - Fax:817-472-9361
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN80582084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry