| Sds Psychiatric Services Llc | |
|
615 Clinic Dr Longview TX 75605-5172 | |
| (903) 212-3105 | |
| Not Available |
| Full Name | Sds Psychiatric Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 615 Clinic Dr, Longview, Texas |
| Authorized Official Name and Position | Shauna Desai Shah (OWNER/PROVIDER) |
| Authorized Official Contact | 9033310506 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sds Psychiatric Services Llc Po Box 2922 Longview TX 75606-2922 Ph: (903) 331-0506 | Sds Psychiatric Services Llc 615 Clinic Dr Longview TX 75605-5172 Ph: (903) 212-3105 |
| NPI Number | 1164890141 |
|---|---|
| Provider Enumeration Date | 09/09/2015 |
| Last Update Date | 09/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164890141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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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 | |
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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 | |
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