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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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