Provider Demographics
NPI:1184037525
Name:RELIANT PARK PSYCHIATRY
Entity Type:Organization
Organization Name:RELIANT PARK PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:
Authorized Official - First Name:IZZELDEEN
Authorized Official - Middle Name:BABIKER
Authorized Official - Last Name:ELHAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-307-7251
Mailing Address - Street 1:7601 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1905
Mailing Address - Country:US
Mailing Address - Phone:713-795-8874
Mailing Address - Fax:713-795-5529
Practice Address - Street 1:7601 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1905
Practice Address - Country:US
Practice Address - Phone:713-795-8874
Practice Address - Fax:713-795-5529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8002103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty