| East Texas Psychiatry Associates | |
|
22 Bermuda Ln Longview TX 75605-2902 | |
| (903) 297-6500 | |
| (903) 663-1085 |
| Full Name | East Texas Psychiatry Associates |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 22 Bermuda Ln, Longview, Texas |
| Authorized Official Name and Position | Shahrokh Safarimaryaki (OWNER) |
| Authorized Official Contact | 9032976500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Texas Psychiatry Associates Po Box 5329 Longview TX 75608-5329 Ph: (903) 297-6500 | East Texas Psychiatry Associates 22 Bermuda Ln Longview TX 75605-2902 Ph: (903) 297-6500 |
| NPI Number | 1790832749 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 09/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790832749 | NPI | - | NPPES |
| 171015401 | Medicaid | TX | |
| 0098KZ | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (Texas) | Primary |
Heather R. Mcconnell, M.a., Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 W Loop 281, Suite 423, Longview, TX 75604 Phone: 903-759-2402 Fax: 903-759-2570 | |
Jonathan C. Lockhart, Md Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 W Loop 281, Suite 111, Longview, TX 75604 Phone: 903-295-8994 Fax: 903-295-8987 | |
Core Health Systems Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1300 N 6th St # A, Longview, TX 75601 Phone: 903-232-8928 Fax: 903-918-1813 | |
Willem H. Fahrenbruck, Lpc, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3122 Nealy Way Ste 201, Longview, TX 75605 Phone: 903-452-8040 | |
Diversified Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1508 W Fairmont St, Suite C, Longview, TX 75604 Phone: 903-238-9553 Fax: 903-291-8709 | |
7872 Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 615 Clinic Dr, Longview, TX 75605 Phone: 903-212-3105 |