Provider Demographics
NPI:1538999370
Name:PREMIUM PSYCHIATRY & MEDICAL
Entity type:Organization
Organization Name:PREMIUM PSYCHIATRY & MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAWWAD
Authorized Official - Middle Name:
Authorized Official - Last Name:YUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-814-5507
Mailing Address - Street 1:424 ORLEANS DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-1128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2026 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-0644
Practice Address - Country:US
Practice Address - Phone:940-320-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty