Provider Demographics
NPI:1144514530
Name:PSYCHIATRIC ASSOCIATES OF NORTH TEXAS PA
Entity type:Organization
Organization Name:PSYCHIATRIC ASSOCIATES OF NORTH TEXAS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-618-2225
Mailing Address - Street 1:6351 PRESTON RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5805
Mailing Address - Country:US
Mailing Address - Phone:214-618-2225
Mailing Address - Fax:214-618-8045
Practice Address - Street 1:6351 PRESTON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5805
Practice Address - Country:US
Practice Address - Phone:214-618-2225
Practice Address - Fax:214-618-8045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN40862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN4086OtherTEXAS MEDICAL LICENSE