| Spectrum Psychiatric Services | |
|
10101 Southwest Fwy Suite 510 Houston TX 77074-1126 | |
| (713) 779-4200 | |
| (713) 779-5866 |
| Full Name | Spectrum Psychiatric Services |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 10101 Southwest Fwy, Houston, Texas |
| Authorized Official Name and Position | Daniel T. L. Tan (OWNER) |
| Authorized Official Contact | 7137794200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Psychiatric Services 10101 Southwest Fwy Suite 510 Houston TX 77074-1126 Ph: (713) 779-4200 | Spectrum Psychiatric Services 10101 Southwest Fwy Suite 510 Houston TX 77074-1126 Ph: (713) 779-4200 |
| NPI Number | 1447396726 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 08/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447396726 | NPI | - | NPPES |
| 132061602 | Medicaid | TX | |
| 10017070 | Other | TX | AMERIGROUP MEDICAID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | J3241 (Texas) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | J3241 (Texas) | Secondary |
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