| 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 |
Faithfully Restored Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 Tristan Ln, Longview, TX 75604 Phone: 903-918-6574 Fax: 903-704-0980 | |
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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