| Summit Behavioral Health Pllc | |
|
4100 Fairway Dr Bldg # 200 Carrollton TX 75010-6525 | |
| (972) 655-9121 | |
| (888) 298-9121 |
| Full Name | Summit Behavioral Health Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4100 Fairway Dr, Carrollton, Texas |
| Authorized Official Name and Position | Radha K. Kambhampati (CEO) |
| Authorized Official Contact | 9726559121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Behavioral Health Pllc 4100 Fairway Dr Bldg # 200 Carrollton TX 75010-6525 Ph: (972) 655-9121 | Summit Behavioral Health Pllc 4100 Fairway Dr Bldg # 200 Carrollton TX 75010-6525 Ph: (972) 655-9121 |
| NPI Number | 1134491046 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 10/04/2016 |
| Medicare PECOS PAC ID | 0840452777 |
|---|---|
| Medicare Enrollment ID | O20120510000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134491046 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | H9099 (Texas) | Primary |
| Provider Name | Radha K Kambhampati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497743546 PECOS PAC ID: 9133198690 Enrollment ID: I20120510000189 |
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