Provider Demographics
NPI:1164763835
Name:JAMPALA PSYCHIATRIC ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:JAMPALA PSYCHIATRIC ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIJAYABABU
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMPALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-628-0246
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76540-0938
Mailing Address - Country:US
Mailing Address - Phone:254-245-9045
Mailing Address - Fax:254-245-9284
Practice Address - Street 1:2407 S CLEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-5721
Practice Address - Country:US
Practice Address - Phone:254-628-0246
Practice Address - Fax:254-526-8643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty