Organization
IKARE MOOD TRAUMA RECOVERY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVINDRA SHAH PHARMD (CHIEF OPERATING OFFICER)
(267) 210-8357
Entity
Organization
Contact information
Practice address
8401 DATAPOINT DR STE 900, SAN ANTONIO, TX 78229-5385
(210) 301-0125
(844) 965-9528
Mailing address
8401 DATAPOINT DR STE 900, SAN ANTONIO, TX 78229-5385
(210) 301-0125
(844) 965-9528
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
Q4829
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP129429
TX
Other
Enumeration date
08/24/2016
Last updated
05/05/2021
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