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Organization
PBH MEDICAL, LLC
Active
Organization
PBH MEDICAL, LLC
Active
Other names
Prime Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VISHAL PANKAJKUMAR SHAH MD (MEDICAL DIRECTOR)
(817) 778-8884
Entity
Organization
Contact information
Practice address
120 RIVER OAKS DR STE 140, SOUTHLAKE, TX 76092-6882
(817) 778-8884
(817) 385-6540
Mailing address
120 RIVER OAKS DR STE 140, SOUTHLAKE, TX 76092-6882
(817) 778-8884
(817) 385-6540
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Q5097
TX
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
Q5097
TX
Other
Enumeration date
01/16/2018
Last updated
01/16/2018
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