| Ai Psychiatry Pa | |
|
2118 E State Highway 114 Southlake TX 76092-6512 | |
| (515) 745-6288 | |
| Not Available |
| Full Name | Ai Psychiatry Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2118 E State Highway 114, Southlake, Texas |
| Authorized Official Name and Position | Adnan Iqbal (OWNER) |
| Authorized Official Contact | 9173368422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ai Psychiatry Pa 301 Boulder Dr Southlake TX 76092-3726 Ph: (817) 960-6627 | Ai Psychiatry Pa 2118 E State Highway 114 Southlake TX 76092-6512 Ph: (515) 745-6288 |
| NPI Number | 1831706100 |
|---|---|
| Provider Enumeration Date | 09/30/2020 |
| Last Update Date | 01/19/2024 |
| Certification Date | 01/19/2024 |
| Medicare PECOS PAC ID | 1951718048 |
|---|---|
| Medicare Enrollment ID | O20210408001165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831706100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Adnan Iqbal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376652206 PECOS PAC ID: 5890837611 Enrollment ID: I20200520000905 |
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