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700 E Vista Ridge Mall Dr Lewisville TX 75067-8339 | |
| (972) 906-9789 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 700 E Vista Ridge Mall Dr, Lewisville, Texas |
| Authorized Official Name and Position | Seema Yasmeen Haque (PRESIDENT) |
| Authorized Official Contact | 9727274440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 250885 Plano TX 75025-0885 Ph: (972) 989-6247 | 700 E Vista Ridge Mall Dr Lewisville TX 75067-8339 Ph: (972) 906-9789 |
| NPI Number | 1952589194 |
|---|---|
| Provider Enumeration Date | 02/08/2008 |
| Last Update Date | 02/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952589194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | K9077 (Texas) | Primary |
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