Organization
SDS PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAUNA DESAI SHAH (OWNER/PROVIDER)
(903) 331-0506
Entity
Organization
Contact information
Practice address
615 CLINIC DR, LONGVIEW, TX 75605-5172
(903) 212-3105
Mailing address
PO BOX 2922, LONGVIEW, TX 75606-2922
(903) 331-0506
(903) 331-0462
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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