| Adult Child & Adolescent Psychiatric Services Pa | |
|
5501 Independence Pkwy Ste 302 Plano TX 75023-5470 | |
| (469) 747-1010 | |
| Not Available |
| Full Name | Adult Child & Adolescent Psychiatric Services Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5501 Independence Pkwy Ste 302, Plano, Texas |
| Authorized Official Name and Position | Mohammad S Khan (OWNER) |
| Authorized Official Contact | 9727097556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult Child & Adolescent Psychiatric Services Pa P O Box 2755 Mckinney TX 75070 Ph: (469) 747-1010 | Adult Child & Adolescent Psychiatric Services Pa 5501 Independence Pkwy Ste 302 Plano TX 75023-5470 Ph: (469) 747-1010 |
| NPI Number | 1194036459 |
|---|---|
| Provider Enumeration Date | 07/01/2010 |
| Last Update Date | 01/31/2019 |
| Medicare PECOS PAC ID | 0244488054 |
|---|---|
| Medicare Enrollment ID | O20120920000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194036459 | NPI | - | NPPES |
| 1194036459 | Other | TX | NPI GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Mohammad A Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528028032 PECOS PAC ID: 6103844683 Enrollment ID: I20101221000968 |
| Provider Name | Davonna Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467693366 PECOS PAC ID: 7810171949 Enrollment ID: I20110413000764 |
| Provider Name | Dominique R Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295019909 PECOS PAC ID: 9133380223 Enrollment ID: I20120417000586 |
| Provider Name | Dorcas O Adeniran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831614965 PECOS PAC ID: 7113293143 Enrollment ID: I20171019000452 |
| Provider Name | Nneka Jon-ubabuco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912274622 PECOS PAC ID: 8022363159 Enrollment ID: I20180613002971 |
| Provider Name | Jashunta Carson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760836399 PECOS PAC ID: 7113279415 Enrollment ID: I20181016000265 |
| Provider Name | Shali A George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760064828 PECOS PAC ID: 1153721261 Enrollment ID: I20210610003471 |
| Provider Name | Maimouna Sow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598375917 PECOS PAC ID: 2567861305 Enrollment ID: I20210611000504 |
| Provider Name | Navdip Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578149787 PECOS PAC ID: 1355748476 Enrollment ID: I20210916000498 |
| Provider Name | Karalee Landers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770251928 PECOS PAC ID: 1456759786 Enrollment ID: I20211018000573 |
| Provider Name | Olayinka Ajofoyinbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477193084 PECOS PAC ID: 3971986852 Enrollment ID: I20220810003477 |
| Provider Name | Centrea Jenelle Holton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013758473 PECOS PAC ID: 5496289134 Enrollment ID: I20241118000817 |
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