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Organization

SENIOR PSYCHCARE OF SAN ANTONIO I, PLLC

Active
Parent organization
PSYCHIATRIC SERVICES, PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PSYCHIATRIC SERVICES, PLLC
Authorized official
RANDALL J. FRAPART CPA (CHIEF FINANCIAL OFFICER)
(713) 850-0049
Entity
Organization

Contact information

Practice address
4635 SOUTHWEST FWY STE 635, HOUSTON, TX 77027-7112
(713) 850-0049
(713) 627-7302
Mailing address
4635 SOUTHWEST FWY STE 635, HOUSTON, TX 77027-7112
(713) 850-0049
(713) 627-7302

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
2084N0400X
Neurology Physician
2084P0800X
Psychiatry Physician
Primary
2084P0805X
Geriatric Psychiatry Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0091WY
BCBS TX
TX
05
288317501
TX
05
288317502
TX
01
DS3800
RR MCR
TX
Enumeration date
06/28/2011
Last updated
12/13/2018
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